THE ART AND SCIENCE OF SOMATIC PRAXIS INCORPORATING US ASSOCIATION FOR BODY PSYCHOTHERAPY JOURNAL volume thirteen ● number one ● spring 2014

E UROPEAN EABP A SSOCIATION FOR B ODY- P SYCHOTHERAPY 2 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Ludwig, USA; Narelle McKenzie, Australia; Linda Marks, Edmund Knighton, PhD, USA;DanielMark Lewis, Serbia; René Kostka, Switzerland; RaeJohnson, PhD, USA; Germany; Rubens Kignel,Brazil; Ljiljana Klisic,Ph.D., Krefft, Germany; Lawrence E.Hedges, USA;Inge Joachim, Haiman, USA;Michel Heller, Switzerland; Sibylle Huerta Elliot Greene, USA;Margit Grossmann, Germany; Claire Gottwald, Germany; Herbert Grassmann, PhD, Germany; Giuffra, Glickman,Mary USA;Christian USA;Gary USA; Nancy Eichhorn, PhD USA;Ruella Frank, USA; Changaris, USA; Will Davis, France/USA; Marcel Duclos, Carbonari, Italy; Fanny Chalfin,USA/France; Michael Bogdanovic, Serbia; ChristineCaldwell, PhD, USA;Fabio Christina Bader, Switzerland; Luisa Barbato, Italy; Sasa Peer Review Board: Germany; Courtenay Young, UK. Germany; Joop Valstar, Netherlands;Halko Weiss, PhD, Maurizio Stupiggia, Italy; Manfred Thielen, Dr.phil. DipPsych, Marlock, Dipl. Päd.,Germany; Professor Frank Röhricht,UK; Clorinda Lubrano, Greece; LisbethMarcher, Denmark; Gustl Brazil; AliceLadas,EdD, USA;Peter Levine,PhD, USA; PhD, Germany; Stanley Keleman, USA;Rubens Kignel, PhD, France; LidyEvertsen, Netherlands; Ulfried Geuter, Fabio Carbonari,Italy; Will Davis, France; George Downing, Bentzen, Denmark; Malcolm Brown, PhD, Switzerland; Australia; Prof. Joachim Bauer, MD,Germany; Marianne Regina Axt,MD,Netherlands; Jeff Barlow, BA,MEd, International Board: Advisory Christina Bader-Johansson, Thomas Harms, German Editorial committee: Tantia, PhD. Asaf Rolef Ben Shahar, PhD; KatySwafford, PhD; Jennifer Nancy Eichhorn, PhD; LidyEvertsen; Michel Heller, PhD; Editorial committee: Editorial Intern: Joshua David Wright illustration: TerryCover Marks Tarlow Cover Design: Diana Houghton Whiting Design/Layout: Ronald Jeans Production Team [email protected] German Editorial Committee: [email protected] Editor:Associate [email protected] Managing Editor: [email protected] Editor inChief: andpracticethrough ongoingdiscussion. theory exchangeinterdisciplinary withrelated fieldsofclinical field ofbodypsychotherapy as well astoencouragean the exchange ofideas,scholarshipandresearch withinthe The Journal’s promote andstimulate missionistosupport, http://www.ibpj.org/subscribe.php. which canbeordered through thewebsite 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 (formerly US Association forBodyPsychotherapy(formerly USAssociation Journal) International Body Psychotherapy Journal The ArtandScience ofSomaticPraxis Jacqueline A.Carleton,PhD Diane Cai Jill van derAa

Elizabeth Marshall, Publishers: retrieval system,withoutwrittenpermissionof thepublishers. photocopying, recording, orby anyinformationstorageand form orby anymeans,electronic ormechanical, including ofthisjournalmaybereproducedpart ortransmittedinany Copyright ©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. mayalso be accepted forpublicationinEnglish, thefullarticle originallywritteninanotherlanguagehasbeen If anarticle http://www.ibpj.org/archive.php Portuguese, Russian, Serbian andSpanish. website inAlbanian,French, German, Greek, Hebrew, Italian, language. Abstracts are ofarticles tobefoundontheIBPJ Translation Advertising: Changes ofaddress: Payment through banktransfer, AmericanExpress orPayPal. Two-year subscription:Members Yearly 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, MD EAP Representatives: Thomas Riepenhausen,Elfriede Treasurer:Eva Wagner-Margetich General Secretary/Vice-President: Jill van derAa President: LidyEvertsen EABP Board ofDirectors 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 Vice President: Dan Mingle, MBA President: Beth Haessig, Psy.D USABP Board ofDirectors Serbian, Maja Lekic;Spanish, David Trotzig. (Brazil) Ronaldo Destri deMoura; Russian, Evgeniya Soboleva; Hebrew, RachelShalit; Italian, Fabio Carbonari; Portuguese DuClos; German, Elizabeth Marshall; Greek, Eleni Stavroulaki; Abstract Translators: Young, UK. Tantia, PhD USA;Halko Weiss, PhD, Germany; Courtenay Sharon Stopforth, Canada;Maurizio Stupiggia, Italy; Jennifer Israel; KathrinStauffer, PhD, UK;LauraSteckler, PhD, UK; Homayoun Shahri, PhD, USA;AsafRolef Ben-Shahar, PhD, Marjorie Rand,PhD, USA;Professor Frank Röhricht,UK; USA; Elizabeth Marshall, Germany; Susan McConnell, USA; isavailable free online.

IBPJ www.ibpj.org EABP [email protected] www.eabp.org USABP [email protected] www.usabp.org The onlineJournal ispublishedintheEnglish [email protected] www.eabp.org/ibpj-subscribe.php [email protected] Albanian,Enver Cesko;French, Marcel   17.50, Non-members 30, Non-members  55.00, Non-members  35 35  20 20  60. 60. 04 TABLE OFCONTENTS 108 Olga Brani, Kate Hefferon, TimLomas,Itai Ivtzan, JoanPainter 95 80 Christian Gottwald, MD 67 52 31 03 ARTICLES 10 08 Jacqueline A. Carleton,Jacqueline A. PhD Editorial Stephanie Pollock, MA Relationship withtheGutBrain The Enteric System Nervous andBodyPsychotherapy: Cultivating a The Role ofMindfulness Dyana Reisen, CT MA, Creation ofContinuing Bonds After a Death Loss Helping theBodyGrieve: ABodyPsychotherapy Approach to Supportingthe Awareness andMindfulness inConsciousness-Centred BodyPsychotherapy Homayoun Shahri,Ph.D., M.A. Toward anIntegrative Model for Developmental Trauma Will Davis The EndoSelf:ASelfModelfor Body-Oriented Psychotherapy? Courtenay Young withGillWestland Jeanne Denney, BS,MA Two Poems Terry Marks-Tarlow, PhD Self-Reflections onArtand Psychotherapy The Impactof BodyAwareness onSubjective Wellbeing: Shadows in the History ofBody Psychotherapy: Part I INCORPORATING USASSOCIATION FOR BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OFSOMATIC PRAXIS volume thirteen

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3 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Editorial enlarge our own creative capacities both in and outside of our work. Art, music, poetry, drama — volume 13 · number 1 · spring 2014 these must be reflected in the selves we bring to our consulting rooms, our research endeavors, and the rest of our lives. Whether we are consumers or producers, participants or spectators, we must be involved. We might in fact think of our work as embodying the art of science. The last two years, as we completed the transition from the USABPJ to the IBPJ, have indeed At our request, body psychotherapist Jeanne Denney, an early contributor to the USABPJ been a time of tremendous movement, change, and transformation. And more changes are on (in the Archives on the IBPJ website, see volume 7#8, 2008), has contributed two poems to the way, in this issue and the next. The USABPJ was basically a two-person operation; I edited it this issue, one from the point of view of herself as patient and the other from the vantage point and Robyn Burns produced it. Today, we have peer reviewers and advisors from virtually every of that same person now as therapist. Ms. Denney exemplifies the union of art and science in continent, along with an editorial committee that assists the editor on an ongoing basis as issues her study of the effects of compassionate presence on hospice patients and the hospice workers arise. We have instituted a system of tracking peer reviews and reviewers (the work of Associate who offer this compassionate presence, utilizing measures of heart rate variability supplemented Editor Diane Cai, recently assisted by Joshua Wright). We have set up a working system that by interviews with caregivers and family members. She brings a background in engineering, flows quite well, but hope that soon the enormous peer-reviewing and proofreading work now childbirth coaching, and body psychotherapy training to her work. And, she writes poems. done manually will be taken over by appropriate programs. Courtney Young, past President of EABP, and Gill Westland, Director of the Cambridge We have initiated our own website, www.ibpj.org. Abstracts of articles are posted on Body Psychotherapy Center, in “Shadows in the History of Body Psychotherapy: Part I”, take THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS the IBPJ website in as many languages as we can find translators for. We have a German a penetrating, sometimes provocative, look at Jung’s concept of the Shadow as it has appeared language editor, Elizabeth Marshall, who heads a whole peer review process in that language to them in the history of body psychotherapy from its inception up to the present. Moving and then translates selected articles into English for the Journal. Honoring the growth, chronologically, they highlight issues such as the historical lack of academic affiliation and all expansion, and constant change in our field, we are pleased that we have been able to keep that has brought, including an anti-intellectual stance on the part of many. They point to the the Journal open access online, charging a minimal fee for print subscriptions. So far, we Freud-Reich split and its continuing effects on attention to the pre-verbal and non-verbal as have been able to do this without a charge to authors (as is becoming customary in open well as attitudes toward touch in the larger psychotherapy community as well as that of body access online journals). psychotherapy. The role of charismatic leaders and competition rather than cooperation among With this issue, we initiate a new cover design for the IBPJ. Joop Valstar, collaborating their followers is explored. Controversies involving boundary violations are mentioned and the with Chiel Veffer, provided both the design and Eugene Brands’ artwork for the initial two relationship of body psychotherapy to humanistic psychology is traced. It is the editor’s hope years of our transition from being the USA Body Psychotherapy Journal to our sponsorship by that this article and its sequel in our next issue will engender some lively discussion, especially both the USABP and EABP, and a new title, International Body Psychotherapy Journal, The among those who have participated in many of the events mentioned. Art and Science of Somatic Praxis. The image on the cover was an oil painting by Brands, Will Davis’s wide-ranging article, “The Endo Self: A Self Model for Body-Oriented entitled Everything Streams, referring to ‘Panta Rei’, the principle (found in the philosophies Psychotherapy,” calls upon physics, biology, and systems theory, making an argument for the of Heraclitus, Plato, Aristotle) that everything moves, changes, and transforms all the time. existence of what he has chosen to call an “endo” self, a coherent subjectivity pre-existent to And so it does. Our new cover has been designed by Diana Houghton-Whiting, somatic the relational self. The endo self, he poses, is the organizing agent of its own experiences, and psychotherapist, who authored an article in our last issue on her treatment of military the obverse of the object relational self. Positing that there has been an overemphasis on the personnel with PTSD. Diana has patiently responded to myriad requests for large and small role of the other in self-development, he describes three themes current in the re-evaluation of changes. The cover art for this issue is from Terry Marks-Tarlow, a California psychotherapist the self as developed through relationship: the existence of a pre-cortical self, the existence of INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL and artist. She generously allowed the editors to choose an image for this issue from the vast a unified organismic self preceding the body/mind split, and the need for a non-deficit model JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL array of her artwork on her website and then agreed to write an introduction to our choice. of human development. He then goes on to elaborate the characteristics of the endo self: a In her “Self-Reflections” she narrates her journey from a primarily “left-brain” approach to primary source, self-referential, abhorrent of splitting, autopoetic, self-regulating, immutable, psychology to a more embodied stance through the lens of her artwork. Dr. Marks-Tarlow possessing a sense of security and well-being, profoundly self-knowing, non-judgmental but has also curated a wonderful collection of therapists’ artwork, some of which we expect will reality oriented, preverbal and nonverbal, spontaneously and continuously reorganizing, and adorn future covers. outside of time. Brief clinical examples illuminate the theoretical material as he draws upon The Fall 2014 issue will also see the inauguration of a new feature edited by Asaf Rolef Ben- multiple sources to buttress his argument. Shahar. He has asked Nick Totton to write an article, which is then commented on by four While Davis emphasizes differentiation, attempting to extricate a pre-existent, self- other prominent body psychotherapists, each of whom is briefly responded to by the original organizing, ultimately immutable self from its later elaboration in relationship, Homayoun author. It is our hope that both Nick Totten’s contribution along with those of David Boadella, Shahri, in an article entitled “Toward an Integrative Model for Developmental Trauma” has Stanley Keleman, Will Davis, and Akira Ikemi will inspire our readers to think and write about championed theoretical integration. Shahri, taking the existence of a self as a given, goes on these and other issues, which, as always, we welcome as letters to the editor and dialogue with to trace its vicissitudes as illuminated by selected theories from the realms of psychodynamics the community at large. (ego psychology, drive-conflict theory, object relations, and self psychology) in addition to The marriage of art and science is of the utmost importance to the Journal. That includes polyvagal theory, complex self-organizing systems theory, and both Reichian and Bioenergetic more than the “art and science of somatic praxis” that hopefully describes our clinical work. writings from somatic psychology. He then presents an extended clinical case to illustrate the As whole human beings, we must, as Dr. Marks-Tarlow reflects in her brief piece in this issue, enmeshing of these perspectives. Shahri and Davis present complementary overviews. Davis

4 5 defends a primal, what he terms “endo”, self, and Shahri addresses its possible developmental Institute for the Psychology of Eating, her yoga teacher trainings, seven years of work with course as that self faces chronic developmental trauma in the form of existential threats or private clients, as well as her own body, and incorporating the body psychotherapy theories and contact deprivation. But both Davis and Shahri bring together complex dynamic systems techniques of Gerda Boyesen, Stanley Keleman, and others, she suggests that paying attention theory with neuroscientific models of the autonomic nervous system, such as Porges’s to how a person’s eating, needing, and sensing (what she designates as the E.N.S. system) are polyvagal theory, and various psychodynamic models, including object relations and Reichian digested in the gut brain can foster consciousness of the ENS. And, ENS awareness in turn can and neo-Reichian theories. increase emotional self-regulation and the ability to respond to the “gut brain” in the moment. Christian Gottwald makes a foray into the area of mindfulness which, as he points out, Naropa University in Boulder, Colorado, requires Master’s candidates in somatic counseling has recently entered mainstream psychotherapy, but which has been practiced by body psychology as a condition of their degree to write a publishable article. The two articles in this psychotherapy schools such as Hakomi for quite some time. An extended transcript of an issue have come out of that provision, as have several we have published previously. Christine initial session provides an illuminating example of initiation and supervision of consciousness Caldwell, the director of the program there, has been a leading force in propelling our field processes with bodily interventions. By simultaneously calling the patient’s awareness to his forward into academic respectability. Students from Naropa’s program and those from other thoughts and bodily sensations and introducing some simple movements, the therapist is able universities represent the wave of the future in somatic psychotherapy. They are seeking academic to help the patient shift from his past and future orientations into the immediate present and degrees for basic knowledge and licensure, and will hopefully continue post-graduate training alleviate his presenting symptoms. Awareness and mindfulness are fundamental to change in one or more body psychotherapy modalities. Earlier on, as Young and Westland point out THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS process. Furthermore, he argues, “a mindful state of consciousness can often become a gateway in this issue, academic degrees were in psychology only, neglecting the complimentary somatic for spontaneous spiritual experiences”. aspect. It is wonderful that today’s graduates have at least been introduced to mind-body work, Dyana Reisen, author of “Helping the Body Grieve: A Body Psychotherpy Approach to sometimes in a course or two, and, sometimes, as at Naropa, as the focus of their degrees. Supporting the Creation of Continuing Bonds After a Death Loss”, brings more than six years of experience in bereavement counseling, research, and hospice work, combined with Jacqueline A. Carleton her Master’s level work in Somatic Psychology at Naropa University, to this article on how New York City and when to employ techniques of body psychotherapy to facilitate the grief process. Before March, 2014 outlining some embodied interventions, she gives us a brief introduction to a number of areas, whose somatic aspects she highlights, of grief and bereavement, including some controversy over whether people benefit from continuing bonds with the departed or should be encouraged to sever them. Focusing on uncomplicated grief, she paves the way for further investigations of somatic interventions in complicated grief as well. Her clear definitions of many aspects of grief counseling constitute a very useful primer. Olga Brani and her colleagues at the University of East London report an intriguing pilot study of the impact of body awareness on subjective wellbeing. After a brief introduction to the mind-body problem as it has been conceived of within psychological literature along with wellbeing and positive psychology, they focus on definitions and possible applications of body awareness and body awareness therapy to the subjective experience of wellbeing. Upon INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL conducting an online survey of 119 individuals from the general population, they find a small JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL but statistically significant relationship between body awareness and subjective wellbeing. In tandem with this issue of the IBPJ, the Spring 2014 issue of Somatic Psychotherapy Today will feature a number of articles, interviews, and book reviews on the burgeoning field of eating psychology. Given what seems to be a worldwide epidemic of obesity along with the prevalence of life-threatening cases of anorexia nervosa and bulimia, this is an important topic. According to Nancy Eichhorn, editor of SPT, the field of eating psychology “shines a spotlight on the dynamic psychological relationship we have with food and its impact on our health and emotional wellbeing. Advances in holistic and functional nutritional health are changing the way we understand the role our diet plays in obtaining and/or maintaining optimal health”. In this issue of the IBPJ, Stephanie Pollock, in “The Enteric Nervous System and Body Psychotherapy: Cultivating a Relationship with the Gut Brain”, explores the role of the enteric nervous system, or “gut brain” in healthy mindbody functioning. In the course of work for her Master’s degree in somatic counseling psychology at Naropa University, she devised a system of working with clients’ enteric nervous systems (ENS), which she handily called the E.N.S. System. Adapting material from the Institute for Integrative Nutrition, the

6 7 Self-Reflections on Art and Psychotherapy figurative style by putting multiple poses on the same page. This innovative technique allows By Terry Marks-Tarlow, PhD me to represent in spatial terms changes in the model’s positions over time. Occasionally, various poses on one page interact with one another in interesting ways. I noticed a new kind of visual synchronicity when a single line served the double purpose (or portmanteau) As a kid, I loved to draw. My mother envisioned a future career for me as a medical of simultaneously representing the edges of two different poses. Clearly, it is no coincidence illustrator. During college, I played with the idea and attended Rhode Island School of that I discovered this phenomenon through drawing at the very same time as I was working Design for a summer to choose between art and psychology. In the end, I rejected the life of on a chapter about synchronicity! an artist. First, I believed I wasn’t talented enough. Second, it seemed too lonely a life. And The image that appears on the cover of this journal, Mother and Child, is very simple, third, I feared I couldn’t support a family. I became a clinical psychologist instead, yet never produced with a single continuous line. My aim was to distill the earliest maternal/infant bond shook my desire to be immersed in the arts. to its bare essence. A portmanteau occurs in this drawing as well—this time between people Following psychology graduate school at UCLA, I developed a specialty in creativity and rather than between poses. The line that depicts the mother’s upper torso simultaneously its various blocks. My first book was a creativity curriculum for educators. After it was done, I depicts the child’s swaddled form. Psychologically, the merged figures represent intertwined had a sobering realization. I had written about creativity partly because I hadn’t been ready to subjectivities. I strived to make visible nonconscious streams of mutual attunement, such embrace my own. Meanwhile, ever leading with my head, I began exploring the neurobiology that mother and infant remain physiologically yoked, despite the severed umbilical cord. THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS of talent. This literature seeded an important idea—that expertise in any field is more related I experience art as an incredibly powerful, healing, and transformative mode of expression. to persistence than talent. Over the past two years, this conviction has only increased with my latest professional Heartened by this research, in the mid-1980s, alongside dance and yoga classes, I returned journey. Past President and fellow Board member of the Los Angeles County Psychological to drawing. Initially, I tricked myself back in after receiving an invitation by the sculptor Association, Pamela McCrory, PhD and I have co-conceived and manifested two rounds Tom Van Sant. Tom held weekly drawing sessions at his home in the Hollywood Hills. Here, of an art exhibition called, “Mirrors of the Mind: The Psychotherapist as Artist.” I had the the Nobel Prize winning physicist, Richard Feynman, regularly attended. I recognized the great honor to curate the show as well as to edit the exhibition art book (go to: tinyurl. privilege of hanging out with such an illustrious character. This thrilling prospect provided com/http-MirrorsArtBook-com). The outpouring of paintings, sculptures, photographs and my initial impetus to produce art again. Meanwhile, I started feverishly reading up on science, other forms of visual art from clinicians of all disciplines and theoretical orientations has especially of the nonlinear variety, in hopes of picking the brain of the reputedly smartest been astounding. Along with their powerful artist statements, the body of work reveals how man in the world, after Einstein. psychotherapists use their creativity to cross-fertilize, heal, rail against, and renew through Although I returned to drawing under false pretenses, I remained for better reasons. My self-expression. This provides a rare opportunity for colleagues and the community at large art became a right-brain mode of communication. I perceived images to carry the power of to peer into the normally veiled, private spaces of the psychotherapist. cutting through where words often couldn’t. I started “seeing” how I could illustrate the myriad Not only does art carry the power to change those who dabble in it, but I believe it also of ideas now springing forth from my newfound fascination with complexity sciences. My carries the power to change the world. Another of my many hats is to sit on the Advisory second book, Psyche’s Veil: Psychotherapy, Fractals and Complexity (2008, Routledge; foreword Board of the Global Alliance for Transformational Entertainment (GATE). This nonprofit by Daniel Siegel), took twelve years and three drafts to write, illustrate, and publish—but I organization (founded by John Raatz, alongside honorary founders Jim Carrey and Eckhart persisted. Tolle) sports the mission of empowering media and entertainment professionals to produce Having played with abstract ideas for decades, I next longed for a more embodied, and distribute content that inspires new awareness-based worldviews for global audiences. INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL grounded focus. I landed on clinical intuition, along with its somatic and brain aspects. Whether as personal growth, during psychotherapy, or through professional organizations, I JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Happily, this topic integrates nearly all of my previous pursuits—creativity, nonlinearity, offer up art everywhere in hopes of creating a better world. embodied practices, implicit processes, and nonconscious sources of inspiration and change. Email: [email protected] Website: www.markstarlow.com/ As I lead with my body instead of my head, my writing has picked up speed. Clinical Intuition in Psychotherapy: The Neurobiology of Embodied Response (2012, Norton; foreword by Allan Schore) took a little over a year to research, produce, and illustrate. Its recently released companion, Awakening Clinical Intuition: An Experiential Workbook for Psychotherapists (2014, Norton; foreword by Allan Schore) flew out of my unconscious in a matter of months. I find that intuition, as expressed through multi-modal channels, is a lovely bridge between soma and soul. The more I dance, draw, and do yoga, the more I develop an embodied awareness of how my art cross-fertilizes not only with my writing, but also with my primary calling as a clinical psychologist. Whereas dance invokes space through time, drawing invokes time through space, and yoga aligns the body both in space and in time. All engage intuition nonverbally, through entrained body rhythms. About ten years after Richard Feynman died and Tom Van Sant’s drawing sessions fizzled, I started holding my own life drawing sessions. Ever so slowly, I have developed a unique

8 9 Two Poems full of faint sound and faint light Jeanne Denney, BS, MA where you hold your tired eye to the looking glass.

Because I am a sometime poet as well as body psychotherapist, I was asked if I would like to contribute a poem or two to the journal. I was honored with this challenge. It provoked me 2. in the best kind of way to be more honestly outward with the inward, exposing a closet self. I immediately thought of old writing from the first years of my own therapy. As a young mother You who walk across the threshold struggling to both find and hold onto a self in the tsunami of four young children, writing opened bearing arms and thistles a means of unearthing the voice and self that was threatened by that experience. alms and roses My therapists of that time were profound and loving men who brought both blessings and wearing corsets and sorrows. Therapy itself raised questions. Like, what was this near mystical “I-thou” relationship I chewing tobacco was a part of? Who was this other? Why did therapy work on such different rules than the ones That howl in your bones is older than you know. for the care I was giving to children? While I struggled, the poetic was the language I found to THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS express my experience and the realms of the unseen that I was becoming aware of. It has chased you across generations in and out of strange places Re-reading these I am so strongly reminded of the great vulnerability and puzzlement that farmhouses, huts clients can experience in the presence of their helpers as well as the preciousness of that passage castles, fields into new understandings of self. The first poem below gives a sense of this raw passage. like a sleuth Later, of course, I became a therapist myself. I have written little to none about this until now. like a sniper The second, recent poem was written from the point of view of a therapist, holding both sides of and here you bring it, weary traveler, looking for mate or a remedy. the mystery. Commissioners of spice, you remind me of soldiers heavy with burden 1. or refugees going from village to village All of the little things that I would tell you mothers looking for food and infants. cluster like so many stars becoming constellations So many turning stars! Your songs don’t usually scare me My job is to hold myself the grim parade trailing behind you so that they appear to be still the tune of the fife in the distance. so that we can find forms in them You pay me mainly for my suffering INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Look! There is an archer in the field! for soup, rose, fire and staff JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL I accept, amazed. In celebration. When I come to sit with you, the constellations vanish Then there is only their after-image I won’t be so grandiose and I am stunned by the flutter of voices as to say left in the chair where others have been Let me carry your banner I add my negative constellations to theirs or Save your village to yours! because A confusion the cricket knows all about. I can’t save your village.

I don’t know how the astronomer looks so long at the night sky Instead, let’s or if he is a lunatic cut a hole in the ice floor, If the apple falls because of these movements and peer at moving fishes or where the car engines are going count Why the sun has always been terrifying the dead or why I have asked you into this night meadow Weep for them together.

10 11 SHADOWS IN THE HISTORY

I (no hero here) will not save you, only say i go ahead, die Shadows in the History of Body Psychotherapy: Part I (at least a little) Courtenay Young and Gill Westland Do It See Received 4 April 2013, accepted June 2013 What happens.

Friend, the howl in your bones? I have it too. Abstract Play me a song on that little flute This article is intended to open up a discussion and to begin to name, reflect on, and I will make a small harmony so that gradually start healing some of the wounds that arose throughout the development of body we can plant trees of forgiveness psychotherapy, particularly during the 1960-2000 period.ii It highlights several problems in lands of milk and honey inherent in individuals single-handedly pioneering new methods, and several systemic Together difficulties in the organization of the original training courses. These Shadows are not unique THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS whistling, to body psychotherapy and similar examples of such issues can be found in many other walking home. modalities of psychotherapy and in many other communities. They have implications for the wider professional field and also the future development of the field of body psychotherapy that, once named and owned, can be utilized more positively. Because of its length, the article BIOGRAPHY has been split into 2 parts. Part II will be published in Volume 13, Number 2, fall. Jeanne Denney is a psychotherapist, healer, teacher and death (and life) educator who maintains a private practice in somatic psychology and energetic bodywork in Haverstraw, Keywords: body psychotherapy, shadow, history, abuse, healing, ethics NY, and New York City. She has been a teacher and mentor at Ramapo College of New Jersey, The Institute for Transpersonal Psychology (Now Sophia University). She currently International Body Psychotherapy Journal The Art and Science of Somatic Praxis leads workshops and teaches at Nyack Living Core Program (Core Energetics). She has spent Volume 13, Number 1, spring 2014 ISSN 2169-4745 Printing, ISSN 2168-1279 Online © Author and USABP/EABP. Reprints and permissions [email protected] years as a doula for death and birth and has raised four children. Website: http://jeannedenney.com/

Introduction

Acknowledging the Shadow Individuals, organisations, countries, and, of course, the profession of body psychotherapy,

all carry their Shadow aspects. Jung saw the Shadow as a merging of unconscious personal

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL elements with various archetypal contents of the collective unconscious. The Shadow also JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL contains the repressed parts of ourselves that we cannot accept and “the less it is embodied in the individual’s conscious life, the blacker and denser it is” (as cited in Samuels, Shorter & Plaut, 1986, p. 138). The Shadow can further contain elements that have not yet emerged into consciousness and thus this part can only be inferred, often in the form of unconscious or subconscious projections. These projections can become stronger and more irrational, individually and collectively, as the contents of the Shadow move towards consciousness. The Shadow cannot be eradicated, but it is possible to learn to live with it, and even use it constructively (Samuels, Shorter & Plaut, 1986). The Shadow and its corollary, the Light, in Jung’s terminology, both have dangerous and constructive characteristics. Only when we “own” the good and bad aspects (of each) can we move beyond these polarities into a more integrated Self. While I use the terminology of the Shadow, I also indicate a process towards higher levels of consciousness (viz., Thich Nhat Hahn’s poem, “Call Me By My True Names”iii). Jung also believed that, “in spite of its function as a reservoir for human darkness — or perhaps because of this — the shadow is the seat of creativity” so that for some, it may be that “the dark side of his being, his sinister shadow... represents the true spirit of life, as against the

12 13 14 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS psychoanalysis from Reich’s aboutNational views Socialism, isdifficultnow tosay. Even interest inthebody psychotherapy, separationof orwhetherthis was a(necessary) involvement withsocialistorcommunistideals, whetherthiswasbecauseofhisincreasing of FascismPsychology Psychoanalytic Associationin1934,about18monthsafterhehad first published Reich possible Shadow aspectsofFreud andthusofpsychoanalysis; there maywell beothers. Germany from the mid-1930s (Nitzschke, 2003). Given our theme, these are some of the an appallingdegree ofcomplicitywiththerisingpower ofNational Socialism, especiallyin Dreams of cocaine addict(Cohen,2011)andthatpossiblyasubstantial part ofFreud,supporters Emperor who didnotlikethesmallboy hasnoclothes.” saying,“The covered upactualsexualabuseandwasnotsurprisingly metwithconsiderablecriticismfrom Masson (1985)revisited thisterritory, usingtheFreud archives, hepostulatedthatFreud had and fantasy, this essential denial. to support developing Whena whole (Oedipal) theory on, herevised histhinkingandsawthesereports insteadasnormalchildhoodlongings tocastsomethingofhisownstarted Shadow especiallywithrespect tothebody. work; and, with all these exclusions and later denials (including Jung and others), Freud then oriented wayofworking. Freud hadalsopreviously rejected thetotalityofPierre Janet’s it,suchasReichsupported andFenichel (Heller, abodily 2012),bothofwhomsupported psychotherapy, helatercametoreject it,andeventually excluded thosecolleagueswho be aware that, whilst Freud originally acknowledged of the body within the importance Freud publish widelyinEnglish). (except, perhaps,intherefusal ordisdainofothercontinental bodypsychotherapists to psychotherapists, andsotheimpactofhisShadow onithasbeenrelatively benignorobscure of bodypsychotherapy. His work hasonlyrelatively recently beenre-discovered by body remarkableis somewhat thatJanet littleinfluenceonthesubsequentdevelopment hadvery of Charcot’s, ofFreud’s andacontemporary duringFreud’s 3-monthstudyvisittoParis, it (Boadella, 1997:Janet, 1925;Kimble& Wertheimer, 1998),beinganelderestablishedpupil Pierre Janet arid scholar” (Jung, 1983,p. 262).Since theemergenceofpsychoanalysis, there hasbeena: COURTENAY YOUNG ANDGILLWESTLAND Whilst Janet oneofthefoundingfathersbodypsychotherapy wasalmostcertainly Reich was one of Freud’s most talented students, yet he was expelled from the International Finally, there isreasonably strong evidencethat,withinpsychoanalytical circles, there was We thatFreud have recently beenpresented theory withafurther wasanunacknowledged Furthermore, atfirsthebelieved hispatientswho had sexualabuse,butlaterreported ofbodypsychotherapy (Young,Those familiarwiththehistory 2006b, 2011)willalso of theirown andhostiletoothers(Jacoby, truths 1990,p. ix). resulting ofschools andmovements, inabroad spectrum allholdinghighthebanners …vast outpouringofresearch, speculation,theorising,analysis,andcontroversy, wasinfluenced by this. (Reich, 1933). Whether thisexpulsionwasbecause ofhisprevious The Founding Fathers Psychotherapy ofBody The Interpretation of The Mass accounts of the newspaper campaignsagainst him andthe investigationsaccounts of the newspaper by the FBI andthe 2014; FBI,1999; Turner, 2011).He eventually diedinprison1957.It seems,from the before theSecond World War, by where theFBI(Bennett, 2010, hecameundersurveillance for six months), and then to Norway, time and finally emigrated to the USA in 1939, a short religions aswell. ofourpsychotherapeuticdenial isalsoalargepart philosophy, andcanbefoundinseveral denied orrejected; itbecomesmore positive andusefulwhenowned andaccepted. This ofitsShadowthe bodybecamepart side.Again,Ireiterate, theShadow isonlynegative when expulsion was“unjust” (Boadella,1973,p. 114).One result ofthisisthat,forpsychoanalysis, Anna Freud (whochaired thecommitteethatexpelledhim),lateracknowledged thathis mentioning himinhisfirstbook, it wasthen,hadtodistanceitselffrom him,evidencedespeciallyby Lowen (1958)hardly and theUSAin1950s(Young, 2006b, 2008,2010) andbodypsychotherapy, suchas like Oedipus, theseedsofhisown downfall. His bookswere burntinbothNazi Germany ofhisShadowlarge part with him. To anextent,hebecamehisown worstenemyashesowed, Food &Drug Administration thathecarrieda (FDA),whoeventually tookhimtocourt, Shadow sidehere. happens alotmore frequently thanwaspreviously imagined.So, there isahugeparallel longtimeformainstream societytoacknowledgetaken avery thatchildhoodsexual abuse Childhood Sexual Abuse — more onthatlater. (and, toanextent,spirituality)isanotheraspectoftheShadow thatneedsto beexamined healing dialogue about the Shadow can be re-opened. Freud and Reich’s disavowal of religion recognising thesecreative andsometimes traumaticfoundations,apotentiallyhelpfuland (Reich, 1948/1972). are aspectsofthehumanShadow thathegraphicallyillustratedsowell in and thushailhimasagenius;itisequallyeasytodismiss himoutofhand.Boththese It easytogetattachedoneormore ofthemanyfacetsthisiconiccharacter, isvery become thesubjectofpopsongs,allwhichheprobably wouldnever have condoned. have this,or that,filmshave claimedthathiswork beenmade,andhiswork supported has it istherefore quitehard abouthim.Many ofbalancedview people tocome toanysort regarding ‘father-figures’ as well. aniconicandcontroversialReich wascertainly figure and that indicated hehadnotresolved any of theseissues;and there were lessobvious issues were andwives definitelyhugeissueswithhismotheras well assubsequentfemalepartners sexually abusedasachild,thoughthispointislessclearinhisbook(Sharaf, 1983). There for BodyPsychotherapy conference, Vienna/Pamhagen, 1997) thatReich wasprobably sense ofself-agency, andSharaf claimed(inakeynotelecture attheEuropean Association Shadow. He himselfwrote ofhisearlychildhoodsexualexperiences(Reich, 1988)witha Boadella’s books(1973,1976)andhisjournal, psychotherapy thenre-recognised himinthe1970s,significantlywithpublicationof and revived, and became influential within humanistic psychology (Clarkson, 1994). Body Reich thenbecamearefugee, firstto Denmark, thento Sweden (eachonavisitor’s visa Irrespective ofFreud’s reluctance toadmittheobvious, ithasalso,incidentally, earlyfoundationsofbodypsychotherapy.These are someofthevery Hopefully by Reich’s lifehadseveral severe traumaticexperiencesinit,somewithadistinctsexual The LanguageoftheBody. Energy &Character.Energy Later, hiswork wasrecognised SHADOWS INTHEHISTORY Listen, Little Man iv

15 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 16 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS over time be given sufficient resources andinfluence that itwillneedtomakethe necessary jointly withUSABP recently.concern untilvery Hopefully theEABP and, asfarIamaware, we have notproperly considered thisaspectasaprofessional I have my doubts that this attitude is properly built into our professional training courses healthy attitudetowards exploring andassessingpotentialimprovements and modifications. general terms—aswithany practice,ortreatment ormethodology—there should bea and efficacyofbodypsychotherapy inmore however, detailelsewhere inthisarticle, inmore within thefieldofbodypsychotherapy. Thankfully, there isalotmore healthyself-examination,especiallyaround thistopic,now touch: thisformofdismissalwouldallow usnottoexamineourown practices properly. dismissing theseopponentsaseitherbeinguneducatedorblinded by culturalmores around concept oflegitimatetouchinpsychotherapy, ourown Shadow we maycarry whensimply remit aboutthe(more ofthisarticle unidentified) Shadows withinbodypsychotherapy. fairly well known andalsofairlyeasilyidentified andtherefore donot really fallwithinthe of Defences; andInappropriate or‘Malign’ Regression” (Young, 2006a,p. 1).But theseare identified asbeingthosearound, “Re-traumatisation; Abusive Touch; the Breaking-Down methods canbepossiblyinappropriate. Anysuchinherent risks: any possible contraindications and incircumstances under which theirvarious techniques or method obviously need to beacknowledged, andtherapists therefore need to betrained in well-covered elsewhere (Young, 2006a). psychotherapeuticThe specificrisksofanyparticular body psychotherapy orwithinbodypsychotherapeutic practice. This topichasbeenreasonably UK, withsimilarincidencesofpopstarsand TV personalitiesabusingtheircharisma. congregation andunderitsprotection; andthe ramificationsofthe Jimmy Savile affairinthe the Catholicchurch “allowing” priestsandnunstocontinueabusingpeoplewithinits isstilloutonthistopic. the jury their veracity, especially as these memories are received with horror and shock. However, regression —ratherthanhypnosis,sedatives orprobing questions— Iamconvincedof has hadclientswhohave recovered suchmemories when underaspontaneousformof after theevent) tofail.Psychotherapy hashadtofacethisShadow side:asatherapistwho thathaspossiblyalloweduncertainty several prosecutions ofchildhoodsexualabuse(long in the“recovery” oftraumaticmemorieschildhoodsexualabuse. This created ahuge the ‘false syndrome’ memory whereby therapistswere accusedofinfluencingtheirclients mid-1980s whenthetopiccameoutof“closet”. It wasalsoreacted tostrongly by COURTENAY YOUNG ANDGILLWESTLAND Recently, manymore incidentsofchildhoodsexualabuseare beingdiscovered (viz: As therapists,we are —perhapsslightlymore aware ofthistopicnow, afterthe I deal with the risk that we carry aboutnotdoinganyproper researchI dealwiththeriskthatwe carry intotheeffectiveness In dealingwiththecontentioustopicoftouchandreactions ofthoseadverse tothe The fourmainrisks,easilyidentifiedwith respect tobodypsychotherapy, have been In we are thisarticle, nottalking aboutanyspecificrisksinherent withinthemodalityof working, goal-orientedtherapy,(Young, andinsufficienttimeforintegration. 2006a, p. 7) theempowerment do notsupport oftheindividual,lackawareness, toohurriedformsof … canbeaddedtoby unethicalpractice,power-trips, theoriesanddoctrinesthat pervasive vi , whichwasestablishedonly recently towork, will andjuststarting Risks Within Psychotherapy Body v ScienceandResearch Committee,working risk ofhubris. the “specialness” with it the inevitable way of working, of our particular we will always carry have ourblindspotsandlimitations,areas ofarrogance andcomplicity. Aswe carry some ofthesemayhave alegitimacy. We toguard againstthem. musttry We willinevitably they are “too this” or “not enough that” — will also be applied to body psychotherapy; and within psychotherapy, ofcriticismsthatare allthesorts carriedaboutothermainstreams — do we needresearch? We know itworks.” changes withinourculture. There isstillabasicattitudeof, “Research? What research? Why and theEABP has beguntograpplewiththese ways. conference times,andwith thefeestructures. However, there are waysofworking withthis resentfulsomewhat and impoverished. Some of these Shadows still haunt us, especially at Western countries seeminglyflourishedandgrew andthosefrom the Eastern countriesfelt well asthehistoric East-West divide,reinforced by thepost-warIron Curtain, where the Southern countries claim a more relaxed and laid-back attitude to organisational issues, as countries are andregulations, seenasmuch tooconcernedwithrules andthosefrom the inevitable “cultural” North-South divides,where peoplefrom theNorthern (Germanic) any degree ofreal cooperation, coherence, andcollegiality:there are, withinEurope, the similar associationsinAustralia andSouth America,butthere isalongwaytogoget associations (USABP&EABP)over thelast10-15years andthefoundingofsomeother within bodypsychotherapy aswell (Westland, 2010). Petruska prevalent Clarkson (1999)describedasschoolismwouldseem tohave beenvery body psychotherapy And healthy thus, or whatsupportive. methods that was not particularly fairly constantbackground ofconsistentcriticalreflection andcomparisonbetween different methods. (perhaps) oftheegotismsomefoundersthose particular There wasa thus schools oftensawthemselves ascompetingwith,ratherthancomplementing,eachother and “dogmatic” aspectthathassubsequentlyhauntedusasaShadow withinbodypsychotherapy. information, perhapswe canusetherest of thequoteforreflection: it really maybethe of Boadella(1987)”: together bodytherapiesandpsychotherapies,that…“with butobserves theexception about bodywork inhis1976bookonhumanisticpsychology, hemuddles butunfortunately often emergingaround atalented,charismaticfoundingindividual.John Rowan writes body psychotherapies, far from being marginalised as they had been, began to proliferate, Cooperation &collaboration So, aswe progress intheestablishmentofbodypsychotherapy asalegitimatemainstream The situationhasimproved withthestrengthening ofthetwomainprofessional For alongtime,untilaboutthemid-1990s, thevarious different bodypsychotherapy If we acceptthiscommentaboutproliferation ofdogmaticmethodologiesassemi-factual As post-World War IIpsychotherapy from developed, the1960sonwards, particularly their than inanyotherapproaches (Rowan, 2001,p. 91). dogmatic. For some reason, this seems to be much more the case in the body therapies of individualpractitionerseachwithamethodaboutwhichheorsheiscompletely One oftheproblems withthebodytherapiesisthattheyseemtoleadaproliferation particular methodasbeingimplicitly“betterthan” particular another’s oranyothers:afactor The Post-War Shadows Psychotherapy ofBody SHADOWS INTHEHISTORY 17 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 18 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS to beoneofthe firsttocondemnthem. not necessarilydirectly connectedwithbodypsychotherapy, ittookabodypsychotherapist processes thatbecame abusive oreven violent(Boadella,1980), andwhilstmostofthesewere ofthe“scene”.part There were alsoseveral more specificinstancesofencounterwithgroup members, or patients/clients. This was not at all confined to body psychotherapy; it was unprofessional. psychotherapy, aswell asoutsideit,thatare now considered unwise,inappropriate, ortotally well. Again,theincredible permissive attitudesin culturalchangesofthiseraledtocertain within this context and therefore carried(or was labelled with) some of these components as charlatans, andwould-be-gurus” (Smith, 1990)and bodypsychotherapy wasalsodeveloping into thecounter-culture. Humanistic psychology atthistimehadits“mavericks, innovators, ever properly attributedtoReich), theBeat Generation (Turner, 2011),andeven passed Many ofReich’s ideaswere eagerlytakenupby Fritz Perls’ Gestalt therapy(thoughnot elements were findingfreer expression, and overly restrictive structures were being overthrown. movement. Major changeswere structural happeninginsociety, where previously repressed or asaresult of, theHuman Potential Movement (Marlock, 1996),andthe1960’s hippie as animplicitcriticismofLowen’s “harsh” formofBioenergetics. if he had still been alive. She may have also used the term ‘Bioenergetics’ in the title of her work influenced by her work as a paediatrician. However, her father might not have agreed with her his footsteps and she softened his work with her form of “Gentle Bioenergetics” eyes. Reich’slater contemporary daughterEva wastheonlyoneofhischildren tofollow in organising trainingsthathadsomeproblematic elements,especiallywhenviewedthrough challenging of the cultural norms, they also sometimes brought about ways of working and some ofhisideas. They were allalsoquiterisk-takingpioneers,but,withtheircreativity and body psychotherapists listed, nonereally Reich knew andallofthemhadborrowed (ordiluted) spirit of the times, and the growth wave of humanistic psychology, from the but, firstapart two bold andcreative innovators (Young, 2008,2010&2011). These innovators allcaughtthe (Ola Raknes, Jay Stattmann, David Boadella, Lisbeth Marcher and Gerda Boyesen) were all Pierrakos, Chuck Kelley, Malcolm Brown, Stanley Keleman, Ilana Rubenfeld, etc.) and Europe post-Reichian developers ofbodypsychotherapy intheU.S.(suchasAlexanderLowen, John themselves and,“ploughed thesamefurrow: over andover again”. not) besignificantthat,sincehisdeath,the muchtoOrgonomists have keptthemselves very for this,itcreates anexclusivity orhierarchy, whichoftencovers aShadow. It may(or medical doctorsshouldbecomeproper Orgonomists). Whilst there are somegoodreasons that still existtothisday(e.g.thatonlyand control (especiallyintheU.S.),settingrules interested inhisideasScandinaviaandthentheU.S.,whichhetendedtoinfluence Humanistic Psychology names”, norreport orspeculation. salaciouslyorfrom rumour modalities (andamongtheirfounders),butforobvious reasons we donotwishto“name that went intocreating some ofthevarious Shadows withinthedifferent bodypsychotherapy COURTENAY YOUNG ANDGILLWESTLAND He becamemuchmore popular, inthe1960’s, particularly 70s,andthenthe80s. These Reich’s were views first taken up in his lifetime, often by small groupings of psychiatrists Now, atthispoint,we needtotakeaslightlydeeperlookatsomeofthefactorsortrends There were, for example, several instances of trainers and therapists sleeping with group Much ofthisperioddevelopment inbodypsychotherapy waswithinthecontextof, vii , strongly excessively integrationoftheexperiencesorinsomecasesregressed withoutthenecessary regression andabreaction —itcouldactuallybecome experienced. trauma andrepression wasintellectuallyaccepted,now —withthedeveloping techniquesof senses, andthusputgreat emphasisonthese. ofchildhoodWhilst thepsychodynamic theory subjective experiences,wantedtofindmuchmore ofaplaceforpeople’s feelingsandthe psychology (andespeciallypsychoanalysis) atthetime.Humanistic psychology valued highly It wasonecomponentofbalancinganover-intellectualised ofhumanbeingswithin view and this was also evident withinseveral ofthe developing bodypsychotherapies in those days. Anti-Intellectualism afforded to training schools by recognised universities is probably a more favourable route. affordedroute. totraining schoolsby recognised universities isprobably amore favourable academic —theirown Shadow —andsotheformationoflinks whereby accreditation is the backofagiantturtle. long-held theoriesthatthesun moves isflatorsits on orthattheEarth around theEarth, ofappropriate scientifictesting,andthereforesort have (perhaps)asmuch relevance asthe many ofourfavoured bodypsychotherapy theoriesover theyears justdonotstanduptoany efficacy —noneofwhichhas really beendoneproperly, yet. Asa result, we mayfindthat favour abitmore academicdiscipline,criticalthinking,scientifictesting,andproof of trainings, itmaywell andrichness,instead have tolosesomeofitsexperientialexpertise we are now beingasked,andrequired, toaddress. and universities stillcarriessomeofthisaversion. This isanotheraspectofourShadow that early 1980s — and we were not unique. The relationship of body psychotherapy to academia bodypsychotherapywas ever demandedofusinourparticular traininginthelate1970sand cultural formofanti-intellectualismarose. nowrittenworkThis wasevidentinthatvirtually There were oftenstatements madesuchas:“Get outofyour headandintoyour body”, anda ofconventional academicintellectual rigourorinvestigationalany sort research parameters. on competencies and therapeutic skills emerged and flourished, with less attention paid to that time.So, abodyofhumanisticallybased,body-centred, experiential,andoftenhands- there. Yet there ofstudywithinanytheuniversities at wasabsolutelynoplaceforthissort mostly experientially, asdidmanybodypsychotherapy trainings,someofwhichstillhappen human capacities” (Esalen,1996)andgenerally blended Easternand Western perspectives, using thetherapeuticrelationship asamedium. the‘armour’“softening sothatthefragileorundeveloped core maygrow of” andexpand, or the“breakthrough”, andnot—asisnow muchmore generallyacknowledged —inthe of thetimesawkeytobodypsychotherapy asbeinginthecatharsis:“breakdown” of theperson,whohadnever really beenabletodevelop thiscore. Many ofthetherapists the (identified) body armouring and the character structure, to a (supposedly) core aspect re-integrating. far outoftheperson’s normal“comfort zone” thatgreat difficultywouldbeexperiencedwith be considered badtherapy. Some oftheabreactions thatwere encouragedtookapersonso person might have been left in a fairlyregressed state, which would now and deconstructed Unfortunately, sometimesthe regressions, often in the formof re-birthing, couldbe done Within humanisticpsychology, there wasalsoafairlystrong anti-intellectualcomponent However, in contrast, manyoftheuniversity-based trainingsare dry, flat,andpredominantly If bodypsychotherapy becomesmore university-based, withMaster’s degree-level The Californiangrowth centre, Esalen,wasfoundedin1962toexplore “unrealized Within bodypsychotherapy itself, there wasstillanemphasison“breaking through” SHADOWS INTHEHISTORY 19 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 20 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS their headsand theirbodiessometimestookover. It took peoplelikeStan Grof (Grof & Grof, much greater insightinto what wasactuallyhappeningwithinpeoplewhentheywent outof orradicalpsychotherapythe anti-psychiatry issues;this,despite thefactthatwe possibly had therapeutic communityinIreland. Boadella, thenfor“People, notPsychiatry”, andthenfoundedAtlantis, anexperimental with Laingbefore goingtoItaly, andJenny James (Ward, 1982)worked firstwith David For example,Jerome Liss,theHarvard-trained psychiatrist andbodypsychotherapist worked Also present were ahost ofcutting-edgespiritualandpsychological opportunities. the RichmondFellowship, aswell asthemore radical“People, Not Psychiatry” movement. There were up, othertherapeuticcommunities starting likethePhiladelphia Associationand and otherswere working inKingsleyHall andlaterestablished theArboursAssociation. experimentation: R.D. Laing (Laing & Esterson, 1964), Joseph Berke, Morton Schatzmann Psychology ground (Southwell, thenforpsychotherapeutic fertile 1988).Londonwasvery and Gerda Boyesen hadmoved from Norway to“swinging” LondontoteachherBiodynamic Norway: Jay Stattmann wasworking inAmsterdam; David Boadellawasworking inEngland; The Anti-Psychiatry Movement body psychotherapy. We maysoonbeforced tochange. no excusing thefactthat,untilrecently, noonereally attemptedtodoproper research into the “natural” scienceofpsychotherapy andbodypsychotherapy (Young, 2012a).But there is trials andotheracceptedmethodsofscientific research are not themostsuitableforassessing prizes”, according thatrandomisedcontrolled toLuborsky etal.,1975),anditisalsotrue actually shows thattheyare allequallyeffective (theDodo Bird hypothesis:“All shouldhave actual research asthere are “proper” few academicsamongstus. effective thananyotherpsychotherapy, well prepared andwe mayalsonotbevery todothe the possibility thatproper research might demonstrate that body psychotherapy is no more be excused. ofour This isdefinitelypart Shadow, inthat we may notwanttothinkabout recently) intotheefficacyandeffectiveness(until very ofbodypsychotherapy cannot really an “edge”, ofourShadow. whichcouldwell bepart body psychotherapy? Mainly becausewe are there notputtingintheeffort: isaresistance, or haveof their training; and so, if these, why not also substantial experiential learning as part Movement Psychotherapy training courses. psychotherapy trainingschoolinDevon). There are alsoseveral UKuniversity-based Dance another psychotherapy aBuddhist-oriented training schoolinLondon, and Karuna, component (forexample,Gestalt psychotherapy attheLondonGestalt Centre, Metanoia, by universities at Master’s degree level and yet have managed to retain their experiential andinvolvementthe publishingofthesesanddissertations, inresearch programmes. up. However, andthere itwouldbeworthwhile wouldbemanyvaluable spin-offs,including someone withaPhD prepared todoalotofhard work togettheaccreditation process set But thisdemandsthetrainingschoolhave someacademicsattachedtoit,withatleast COURTENAY YOUNG ANDGILLWESTLAND Finally, ofthisanti-intellectualism,theappallingpaucityanyproper research asapart Nowadays, mosthumanisticpsychotherapy coursesintheUKare beingvalidated Meanwhile, bodypsychotherapy effectively stoodontheside-linesandducked manyof There ofideasandexperimentationamongst thesepeople. wasawidecross-fertilisation In Europe, inthe1970’s, there were theremnants ofthepre-war Reichian schoolin It thatthesepointscanapplytootherpsychotherapies istrue aswell: muchoftheresearch viii All of these arts therapyMaster’s Allofthesearts programmes in the1970’s, there wasmore emphasisoncatharsisandin-depthexperience,sexual its implications. Within manyhumanisticpsychology andalso body psychotherapy trainings more sexuallyrepressive elementsinsociety, butwithoutsufficientthinking-through ofall simultaneous development ofthecontraceptive pill)inthe1960’s, liberatedsomeofthe Issues Boundary of hiswork withLSDandatEsalen. experiences intothedifferent forms of‘spiritual emergencies’ that hedescribedcoming out (incidentally, notaformofbodypsychotherapy), toenvisageandincludeKundalini-types of 1990), whofoundedtheHolotropic Breathwork formofbody-orientedtherapytechnique value. In hertrainings, Gerda Boyesen also saidfrequently, “LessisMore”, and spokeofa the ‘out-stroke’, andthatcontainmentexpression offeelingseachhaditsplaceand and Davis (1984), were alsobeginning to recognise thevalue of the ‘in-stroke’, as well as rather thanexaminethemethod. littleoftheresponsibility,the trainerwouldoftentakevery preferring toblame theperson or group memberre-integrate. Occasionally, thepersonwouldhave apsychotic episode,and or resident therapists,whowouldhave tohelppickupsomeofthepieces,ortrainee enormously powerful, individuallyreactive itwouldbethelocal experiences,butafterwards therapy” —andsopeoplecamebackformore. would bequiteprovocative; yet thiswas—inthemétieroftimes,stillconsidered “good Sometimes, themethods, quite ortechniques powerfulused by these trainers interventions, him orherself. There forfeedback,opendiscussion,ordebate. wasalsolittleopportunity be anythingconsidered essentially“wrong” withthe charismatic, internationaltrainer, expectations would be fulfilled, sometimes they were disappointing, yet there would never from abroad bringinghugeexpectations ofpowerful methodologies.Sometimes new these psychotherapy trainings,where aguesttrainer(withconsiderablecharisma)mightflyin and regarding contentiousissue. avery to establish proper1998), whichwere boundaries in a(now) trying fairlyde-regulated field Jarlnaes (1993).Other bookswere alsobeingwrittenlike and practiceinbodypsychotherapy, forexample,thework ofMacNaughton, Bentzen & Therapy”. suchasSouthwell’sand thisledtoseveral articles, in Sexual Boundary “The (1991)article, (Boadella, 1980,p. 9). Reich, peopleandwas“against never hurt drasticmanipulationsandheavy muscle-pushing” psychotherapy groups, andhequotesEva Reich commentingthatherfather, Wilhelm that existedinsomeencountergroups, aswell ashumanisticpsychotherapy andbody question someofthemethodsbeingemployed inthenameofbodypsychotherapy. boundaries were oftenquitefluid. However, by the1980’s, various people were beginningto Clance &Imes, 1998)and The openinguptogreater sexualfreedom andindividualsexuality(withthealmost Yet, itwasnot allextroversion andcatharsis;someofthetheorists, likeBoadella(1986) intothegroup forward member(s)having This formofidealisationcouldcarry There wasalsosomeimplicitquestioningofthestyleteachinginbody During the1990’s, somemore, ordeeper, reflection wasbeginningtobegiven toethics Greater thinkingaboutappropriate sexualboundariesoccurred throughout the1980’s Boadella (1980)hadalready questioned thesometimesextreme levels ofviolence The Ethical Use of Touch inPsychotherapy Touch inPsychotherapy SHADOWS INTHEHISTORY (Hunter &Struve, (Smith, 21 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 22 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS especially to the young. especially tothe young. and sects—setupby theanswers thosepeoplewhosaidthattheyknew —muchmore attractive, the Second Vatican Council (1962-65), but that also made various religious and spiritual cults that not only prompted the primacy of conscience and greater religious freedom epitomised in alongside increasing materialism, have allhelpedtocreate adegree ofrootlessness, asenselessness tsunami, populationexplosions, ever increasing numbersofrefugees, youth unemployment conventions, thewidening oftheindustrialrevolution intoatechnological andmaterialistic etc. —beingprosecuted forlong-termsexualabuse ofclients. today ofeminentpsychiatrists, psychologists, andpsychotherapists —aswell asdoctors, dentists, none ofthesewere orsuccessfullyprosecuted. ever takentocourt There are similarprosecutions from othermodalities:there are salacious storiesaboutFerenczi, Jung, Perls, andKahn,though depth re-education isnecessary. stereotypes difficultto eradicate,as — even after investigation and it is also very —a lotof in- of Shadow andperniciousasitlinksintoseveral politico-social quitepervasive is(unfortunately) to the therapists and also trainers need totrack that he this trained forward or inspired. This sort due course,needtotrackthisbackthecharismatictherapist(s)whotrainedhim;andwe may peri-natal psychotherapy aboutriskfactorsinthewomb(Krens &Krens, 2006). formofabusewaswrappedupinpseudo-scientificwork todowithpre-natalthis particular and “the warmth and security” that they had had to do without. taken littlenoticeoffrontiers” andimaginedthathewas“a pioneer” andwasgivingthesepeople age.Apparently,therapy worked onlyforwomen,andthenwomenofacertain he“has so hisdefencethatthiswas“scientific” wasignored. One judgeasked,appropriately, whetherthe In hisformative years asatherapist,itwasnotthecustomtotakenotesorkeep medicalrecords, beingnaked,andtheclientortrainee’sparticipants clitoralandvaginal areas beingstimulated. method. He hadcalledit“experimental skincontactwork”, embryonic butthisincludedboth were possiblyatleastanother160-180people thathehad“treated” inthisso-called“scientific” on practicing,withfairlysubstantialdamagesbeingpaidtothefourcomplainants,althoughthere with a three-year sentence, twoinprison and one year onprobation, and an eight-year limitation and continuedtogive therapyinwhatbecameincreasingly unacceptableways. theirabusivehave practices initiallytrainedinthoseearlierunboundedperiods,didnotcurtail psychotherapies) happilygot“ironed out” inthe1990’s. However, sometherapists,who may that person. contra-indications, oreven ofdoingariskassessmenttheappropriateness ofthattechniquefor disavowal of responsibility for the technique, and might also indicate a lack of consideration for the personhaving“insufficientegostrength tocopewith thepowerful forces oftheid”.a Thisis whichwere oftenputdown tothe“powerfulgroups, effectsofKundalini rising” inadditionto (seemingly) psychotic episodesafterBiodynamic therapysessions,orexperiencesintraining “subtle approach” tobodypsychotherapy; andyet, there were stillinstancesofpeoplehaving COURTENAY YOUNG ANDGILLWESTLAND One such(dare we say it, body-oriented) psychologist andpsychotherapist endedupin court, Most ofthesetypesusesorabuseswithinbodypsychotherapy (aswell asinother The catastrophic warsandsocialupheavals oftheearly20thcentury, thelossofestablished It ofbehaviourhasalsobeenascribedtopeople notingthat,by allaccounts,thissort isworth Unfortunately, this one publicized example mightbejust the tip of theiceberg. We may, in The Lossof Values andSpirit ix A lot of the so-called theory behind behind A lot of the so-called theory Jonestown inGuyana in1973;Sun Myung Moon themore started successfulMoonies Manson foundedhis“Family” inCalifornia in1968;Jim Jones setupthecatastrophic Rajneesh hadanenormousfollowing from themid-1960sonwards (Mann, 1987);Charles (like Quaesitor ortheOpen Centre inLondon) and/or communitieslike(orin association happened withinprivate spaces,orlargerrented centres, orinassociationwithothercentres its own versions of organised asprivate businesses,sometimesowned by anindividualor family, andeach taught self-referential.self-published, un-edited,not peer-reviewed, andvery The trainingswere and bookspublishedby internationalpublishinghouses, and therefore muchmaterialwas operated almostasanunderground movement (Boadella,1991).It washard togetarticles psychotherapy,. But bodypsychotherapy alsofunctionedwithoutmuchrecognition and Closed Communities Limits ofDividing Reality intoDistinct Realms ofKnowledge”. of the Soulwith the Certitudes and ending with the Ambivalences of the Mind” and “The of these long-term changes in trends and attitudes, especially when he writes about “Starting back inretrospect. toswing backabit,butweswung; itmayhave shallsee.It started isstilltooearlytolook trends. We mayhave thrown thebaby outwiththe bathwater. The pendulumcertainly materialism,the“let-it-all-out”ally themselves withthenew andthe“have-it-now” cultural work, professionalism, research, discipline,thrift,etc.Some trends ofthesenew seemed to especially afterthe1960s,there were manyvalues thatnow seemedtobeold-hat:hard body psychotherapy becamealittlebitmore likesectsthanprofessional trainings. charismatic founder. Thus, ithastobesaid,sometrainings,schools,orinstitutionswithin of finding deeper values and getting backto the “core”, often underthe guidanceof a trends with the proliferation of competing methods, all with their unique answers, sense often seemattractive astheyofferadifferent value system. attractive. But waysget insidethebody-mind(ratherthanhead)canseemvery thesenew someone abettersenseofdirection, aninternalfocus,asenseofself, methodto andanew (Singer &Lalich,1996).In aworldwhere almost“anything goes”, anythingthatgives smaller sectsandcults. the Scientologistswere by L.Ron started Hubbard inabout1953. There were manyother (Unification Church) inthemid-1950s,whichnow has over five millionmembers;and In the post-WW2 era, the Maharishi Mahesh Yogi influenced the Beatles; Bagwan Shree Much ofthisexperimentationwas,outnecessityoutsidethemainstream of Michael Heller, in his (2012) encyclopaedic work on body psychotherapy, points to some At thesametime,witheasingofmorality, andthechangesinvalue systems, Some people,insomeaspectsofbodypsychotherapy, alsocapitalisedonsomeofthese Many ofthesemovements were notallbad,butmanyofthemwere alsoalittlecrazy p. 24-25). our boredom isthefactthatwe have lostallsenseofspiritualvalues. (Zaehner, 1974, is inanguish,itmad.But theroot ofourmadnessisboredom, andtheroot of The modernworldisbored; andbecauseitisbored, itisinanguish;andbecause traditional values. left of our Christian traditions butthat we have lost orthrown overboard allof our The trouble isnotsomuchthatwe have totallylosttouchwiththelittlethatis its x methodsandtheory. Many smallertrainingsorencountergroups SHADOWS INTHEHISTORY 23 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 24 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Boadella was developing his form of Biosynthesis; and there were transatlantic a few Biodynamic Psychology. Jay Stattman was developing his Unitive Psychotherapy; David offs, likeLillemorJohnson, LisbethMarcher’s Bodynamics,andeventually Gerda Boyesen’s psychotherapy inScandinavia,theCharacter-Analytic Vegetotherapists, spin- withafew clarity andsubsequentlyanimprovement instandards and ethicshasoccurred. Ironically, by “closing thedoor” anddefining bodypsychotherapy more precisely, agreater first USABPconference inBoulder, CA,in1998, which wasonlyforbodypsychotherapists. openandincludedmanyforms ofbodytherapy,was very dancetherapy, etc.—andthe between thefirstUSBody Psychotherapy conference in Beverley MA,in1996—which just inapsychologically-oriented body therapy. This formofdifferentiation wasapparent 2010), andsomeofthemwere now more solidlybasedwithinpsychotherapy, ratherthan Formative Psychology, and Malcolm Brown’s Organismic Psychotherapy, etc. (see Young, Rubenfeld Synergy, Bodynamics,Rosenberg’s Integrative BodyPsychotherapy, Keleman’s accreditedrunning Masters (andsomeDoctorate) programs inSomatic Psychology. was recentlywhich unfortunately bought out by the University of Chicago. All of these were of Integral Studies (CIIS)inSan Francisco, andlatertheSanta Barbara Graduate Institute, in Boulder, Colorado. Then cameJFKUniversity inBerkeley, CA,theCalifornia Institute the wholeacademicsidebegantogetmuchmore involved. One ofthefirstwasat Naropa, ofourShadow.been anotherpart adherents, andthere were noresearch virtually projects. This formofclosedcommunityhas conceptsandmethodsonlytothe oftendisseminatednew small numberofjournalarticles There conferences were few where could bedisseminated,arelatively very wider views to lendadegree quitesmallandobscure ofrespectability trainingcourses. totheseotherwise Institute inRhinebeck,up-stateNew York, were oftenusedtohostsuchtrainingsandalso was goodorthat“that” were wasnot—andoftentheseviews quitepejorative. centres, whichmeantalessreflective formofcommunication. We tooktheirword that “this” wasdone,ifatall,through themaintrainers,orthroughinterface thefoundersvisitingother psychologists, psychotherapists, or even with other body psychotherapists. Most of the Synergy, inNew York. People inthesetrainingsdidnotcommunicatemuchwithother Rubenfeld trainingsmallgroups inherformofbodypsychotherapy, started Rubenfeld the 1980’s progressed intothe1990’s, Ron Kurtz’s Hakomi togrow work started andIlana prior tothe1990’s: Stanley othersworked Keleman andafew quiteindividually, andas their journalswere more widelyavailable. muchtothemselves,working, withquiteexclusive keptthemselves very criteria,even though Chuck Kelley’s Radix work in third place. The Orgonomists, the inheritorsofReich’s wayor essentially Lowen’s Bioenergetic AnalysisandJohn Pirrakos’s Core Energetics, withpossibly 2002; Young,2011). quite cliquey. This didnotchangesignificantlyin (Westland,Europe untilaboutthe1990s (perhaps unconsciously)hidethemselves awayalittle. The trainingstendedtobesmalland with) centres by (somethinglike)Bagwan run ‘sanyasins’ (disciples)—andthus could COURTENAY YOUNG ANDGILLWESTLAND The other body psychotherapy trainings all tended to be quite small and very individualThe otherbodypsychotherapy trainingsalltendedtobequitesmallandvery In theU.S.,in1960’s and1970’s, themainbodypsychotherapy trainingswere In Europe, uptothe1980s, there were theremnants ofthe “golden age” ofbody By the2000s,there were alsoaplethoraofbody-orientedtrainingcourses:Lomi, It wasn’t untilthe1990sthatsome educational centres expanded into universities, and Larger workshop centres, liketheEsalenInstitute inBig Sur, California,ortheOmega Through theirclosure, theycanalsohideabuses. dialoguing withdifferent perspectives orconforming toexternalstandards andregulations. of beingandworking together, withoutthe naturalchecksandbalancesthatcomefrom (like rehabilitation), butclosedcommunitiesare alsocharacterisedby embeddedways a protective outcome spaceforthedevelopmentideas,orfocusingonaparticular ofnew vulnerabilitiesbecauseofitsinwardhas certain organisation. These communitiescanprovide back over. But allofthesetrainingsandmethodswere –uptothenrelatively closed. Europeans madethejourneyacross andtrainedintheUSAthen brought themethod influences, with Lowen and Pierrakos coming over anddoingtrainingworkshops. Some USABP &EABP) andsocanbeconsidered closedinthiscontext. stillsomewhat done soby havingrelatively littlecontactwith otherbodypsychotherapy organisations(like cliques. andisstillflourishinggreatly toitscredit,That ithassurvived butithasalso and trainingorganisation,was alsonotwithoutitsown severe difficulties,tensions,and controlled by Lowen, tobecominganindependentprofessional and internationalassociation psychoanalysis andalsoPsychosynthesis). splits have happened with other schools and withinother modalities of psychotherapy (viz. organisations oftheUKCP embraced widerhorizons and are alsomoderatedexternallythrough their statusasmember eventually hadtobetotallyre-founded astheLondonBiodynamic School.Allhave now Centre, theoriginalbranch(containingfounder, Gerda Boyesen) diminishedand the Chiron Centre andlaterwithanotherspin-offintotheCambridgeBodyPsychotherapy community alsosplitintheearly1990s,andwhilstone branch flourished,turninginto emotionally painfulforthoseinvolved. In London,theBoyesen Biodynamic Psychology also, toanextent,theHakomi community, didsplit,andby allaccountsthesplitswere quite rumour. However, anumberofbodypsychotherapy communities,likethatwithinRadixand external regulating forces. Inevitably, there were alsosomeabuses. or whoshouldleave. There were checksandbalances, littleinternaldemocracy, few andno structure thetraininghow theyliked,andalsodeterminewhosucceeded inthetraining,and/ charismatic leaders essentially quite a free reign to do what they liked, charge what they liked, especially withintheactualbodypsychotherapy trainingschools. This allowed thefairly of psychotherapy, there was a tendency for relatively more closed systems of organisation, because between 1960 and 1980, within body psychotherapy and in several other forms ofthesecommunities(Brumann, 2000). such leadersactuallyinhibitedthesurvival credited withquasi-religious status,beingconsidered ormessiah,but somethinglikeaguru closedatfirst,whichisrare. very closed sectsortrainings.One communitycalledDamanhur (inItaly) opened up after being (USA), Auroville (India), aswell asmanyothersespeciallywhencontrastedwiththemore in the1960’s and1970’s periodfor example,Findhorn (Scotland),Esalenand The Farm in thewide-rangingspateoffairlyopenalternative communitiesthatdeveloped, especially successful,butmayloseoutonqualityanddepth. seem very There isclearevidenceofthis Open communities are more expansive and welcoming, can be evangelistic, and may Any closedcommunity, suchasareligious order, cult,sect,prison,orresidential facility, By allaccounts,the transitionwithinBioenergetic Analysis,from beingalmosttotally Again, we reiterate thatwe donotwishto“name names”, nortoreport salaciously, orfrom The recognition ofpotentialdifficultieswithinclosedcommunitiesissignificant Such communities mayhave beenfoundedby charismaticleaders,whowere sometimes xi , which,interestingly, didnotexistuntiltheearly1990s.Similar SHADOWS INTHEHISTORY 25 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 26 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS psychotherapy andbodypsychotherapy. we mayhave tolookattheShadow ofexclusivity. ofthissort tohave anextensive (4-year) groundingexperience –itisnecessary inthatexperience.So, the otherhand,itisclaimed that–asbodypsychotherapy isessentiallydonefrom afelt an already trained body psychotherapist can do a 2-year gestalt conversion course: on profession andwouldapplyinreverse; of facilityisavailable innearlyevery hand, thissort course” or2-year additionaltrainingintheessenceofbody psychotherapy. On theone in agestaltorpsychodynamic trainingcourse),onecannotthenjustdo a “conversion body psychotherapists. therapists oroutcomes(Postle, 2000).Some are of theseviews alsoheldstrongly by some of organisationalpower, andthelackofanyreal evidencethat regulation produces better controls andstructures, adistancingofclientandtherapist,abuseregulation, unnecessary an irrationalfearofsectsandcults. of Psychiatrists, 1983).However, thelargely unacknowledged (Shadow) reasons seemtobe the employment oflaypsychotherapists intheUKNational Health (Royal Service College protection profession, ofpatients,andtheestablishmentanew whichwouldalsoenable on. rumbled The statedmotivation forregulation wastheraisingoftrainingstandards, the and pioneeringofmethods.He reported: perspicacity, Foster recognised theinherent problem ofpsychotherapy, namelydependency psychology, aBritish government wassetup, chaired inquiry by Sir John Foster. With psychotherapy (Miller, 1987). activelyand attackingpsychiatry When Scientologystarted this organisationandwhetheritisacultorwhether, typeof asithasstated,isanew wayofbeingcalled“gettingand anew clear”. There was,andstillis,great concernabout groups andofficesinmanycitiesinternationallyoffered personalityquestionnaires Psychotherapy Regulation also similarexamplesinvarious religious sects andcults. psychoanalysis, excellent references are Makari, G.(2008)andHaynal, A.(1987).” There are among pupilsisawell-known phenomenoninmostpsychotherapeutic modalities.For Shadow sideofbodypsychotherapy. been managedwell, there isoftenlong-lastingpainandhurt. This istherefore ofthe alsopart differing parameters,isadifficultone. Where thesetransitionshave nothappenedeasilyor founder orleader, toawider, more opencommunity, withperhapsseveral centres and COURTENAY YOUNG ANDGILLWESTLAND Meanwhile, theChurch ofScientology, foundedby L.Ron Hubbard in1953,had One ofthereviewers commented:“Similarly, ofthisarticle theintolerancefordeviance The transitionfrom a small closedschool, centred around anoften gifted or charismatic These criticisms are someoftheShadows of increased professionalism within There are alsostrong heldthathavingtrainedasadifferent views psychotherapist (say, There are valid fears and worries about also, over-it must be stated, some very Since then,thedebateonpsychotherapy regulation intheUKandEurope has weakness tothetherapist’s profit (1.para.258). only for the good of the patient himself, and never for the exploitation of his patient’s dependence whichflows from theinherent inequalityofthe relationship its techniques,andtrained—asallorganisedprofessions are trained—tousethe for reward should be restricted to members of a profession properly qualified in …I have becomeconvincedthatitishightimethepracticeofpsychotherapy xii

written a number of articles fortheEAP’swritten anumberofarticles of aEuropean Psychotherapist fortheEAP(www.psychotherapy-competency.eu). He has has recently beenheavilyinvolved inaproject toestablishtheProfessional Competencies Body Psychotherapists (EABP),andtheEuropean AssociationforPsychotherapy (EAP).He of theUnited KingdomCouncilforPsychotherapy (UKCP), theEuropean Associationof and psychotherapist intheNational Health inScotland.He Service ontheBoards hasserved humanistic, transpersonalandbody-orientedmodalitiesalsoworking asacounsellor Arnold Mindell, amongstothers.He isnow anaccredited psychotherapist, working within David Boadella,andwithsignificantinputsfrom John Pierrakos, andlater Stan Grof and Courtenay Young trainedinbodypsychotherapy over 30years ago,withGerda Boyesen, BIOGRAPHIES Body Psychotherapy trainingoffered atCBPCisrooted inapsycho-spiritual perspective. He hashadonebookpublished, Character USABP Journal, editor ofthejournal, Psychotherapy programme atAngliaRuskin University, Cambridge, UK. She isalso co- School ofBiodynamic Psychotherapy, ontheM.A.Body London,U.K;andasupervisor External International Examiner fortheKaruna Institute inDevon, U.K.andtheLondon She isafullmemberoftheEuropean AssociationforBodyPsychotherapy (EABP);an Hospital, Cambridge,asaclinicianandthenmanager, andteacher. clinicalsupervisor Health in Mental Service Health at the Maudsley Hospital, London, and then at Fulbourn for thepast30years. She worked originallyasanoccupationaltherapistin the National as abodypsychotherapist formanyyears andhasbeentrainingbodypsychotherapists registered bodypsychotherapist, trainer, supervisor, consultantandwriter. She hasworked Gill Westland isDirector ofCambridgeBodyPsychotherapy Centre (CBPC)andaUKCP Books in2015. Psychotherapy editing theEnglish-American version ofthe onvarious topics,asadirectorarticles ofBodyPsychotherapy Publications. He iscurrently (AuthorHouse, 2011).He alsopublishesaseriesofcollectionsbodypsychotherapy and haspublishedanother, Email: [email protected] Email: [email protected] Editor’s Note: hasbeensplitintotwo parts. Becauseof itslength,thisarticle , and has also written other articles inotherjournalsaswell aschaptersinbooks., andhasalsowrittenotherarticles The References and Endnotes are locatedattheendofeachpart. withGustl Marlock &Halko Weiss, duetobepublishedby North Atlantic the Journal ofBody, Dance &Movement inPsychotherapy, Body, Movement andDance inPsychotherapy First ContactswithPeople inCrisis andSpiritual Emergencies Help Yourself TowardsHealth Mental ______International Journal ofPsychotherapy, Handbook ofBody Psychotherapy andSomatic SHADOWS INTHEHISTORY (Taylor andFrancis). The (Karnac Books,2010) and Energy & Energy for the

27 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 28 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Laing, R.D.&Esterson, A.(1964). Krens, I.&Krens, H. (2006). Kimble, G.A.& Wertheimer, M.(1998). Jung, C.G. (1983). Jung, C.G.(1938). Janet, P. (1925). Jacoby, M.(1991). Hunter, M.&Struve, J.(1998). Heller, M.C.(2012). Haynal, A.(1987). Grof, S.&Grof, C.(1990). FBI (1999).Project Megiddo, FBIStrategic Assessment,October 20,1999,retrieved 2007-07- Esalen Catalog, Davis, W. (1984).AnIntroduction totheInstroke. Cohen, D.(2011). Clarkson, P. (1999).Eclectic, integrative, andintegratingpsychotherapy orbeyond ‘schoolism’. Clarkson, P. (1994).Chapter1: The nature andrangeofpsychotherapy. In: P. Clarkson &M. Brumann, C.(2000). The Dominance ofOne andIts Perils: CharismaticLeadershipandBranch Boadella, D.(1986). What isBiosynthesis? Boadella, D.(1980). Violence in Therapy. Boadella, D.(1997).Awakening sensibility, recovering motility. Psycho-physical synthesisat Boadella, D.(1991).Organismus undOrganisation: Der Platz derSomatischen Psychotherapie Boadella, D.(Ed.) (1976). Boadella, D.(1973). Bennet, P.W. (2014). Wilhelm Reich, The FBI,and The Norwegian CommunistParty: The Bennett, P.W. (2010). The persecutionofDr.Wilhelm Reich by thegovernment oftheUnited REFERENCES COURTENAY YOUNG ANDGILLWESTLAND Consequences ofanUnsubstantiated Rumor. States. Vanderhoeck &Ruprecht Verlag. DC: AmericanPsychology Association. Series: Princetown University Press. (edited by Read, H.,Fordham, M.&Adler, G.,translatedby Hull, R.)Bollingdon London: Routledge. CA: Sage. Norton &Co. to Michael Balint. 03: http://permanent.access.gpo.gov/lps3578/www.fbi.gov/library/megiddo/megiddo.pdf. 314). London:Sage. In Palmer, S.& Wolf, R.(Eds.) Pokorny, Structures inUtopian Communes. International Journal ofPsychotherapy, the foundationsofbody-psychotherapy: the100-year legacyofPierre Janet (1859-1947) Society]. in derGesellschaft [Organism andOrganisation: The Place ofSomatic Psychotherapy in International Forum of Psychoanalysis, Energie undCharacter, The Handbook ofPsychotherapy. September 1996-February 1997 Principles ofPsychotherapy Freud onCoke The techniqueatissue.Controversies inpsychoanalysis from Freud andFerenczi Memories, Dreams, Reflections. Individuation andNarcissism, of Self inJung thePsychology andKohut. The Collected Works ofC.G.Jung, &Religion Book11:Psychology London:KarnacBooks. Wilhelm Reich: The evolution ofhiswork. Body Psychotherapy: History, concepts,andmethods. In the Wake ofReich. The Stormy Search fortheSelf. LosAngeles: Risikofaktor Mutterleib [Womb RiskFactors]. . London:Cutting Edge Press. The Ethical Use of Touch inPsychotherapy. 22,61. Integrative andeclecticcounseling psychotherapy, Sanity, Madness, andtheFamily. Journal ofAnthropological Research, Vol. 2(1),45-56. Portraits ofPioneers in Psychology: Energy &Character,Energy Energy &Character,Energy London:Routledge. . London:Allen&Unwin. London:Coventure. 19:51-65. . Big Sur, CA:EsalenInstitute. Psychoanalysis andHistory, London:Flamingo. Energy &Character,Energy London: Vision. 11(1),1-20. 17,(2),1-24. London: Tavistock. Tarcher. 15, (1), 17-26. 15,(1),17-26. 56(4),425–451. Göttingen: Göttingen: Vol.3. Washington, New York: W.W. 16(1),pp. 95–114. Thousand Oaks, Thousand (305-

Smith, E.W.L., Clance,P.R. &Imes, S.(1998). Touch in Singer, M.T. &Lalich,J.(1996). Ward, J. (1982). The Atlantis ofJenny James. Turner, C.(2011). Southwell, C.(1991). in The Sexual Boundary Therapy. Southwell, C.(1988). The Gerda Boyesen Method: Biodynamic therapy. In Rowan, J.& Smith, M.B.(1990).Humanistic Psychology. Sharaf, M.(1983).Fury onEarth: Samuels, A.Shorter, B.&Plaut, F. (1986). Royal CollegeofPsychiatrists. (1983).Statutory Regulation ofPsychotherapists. Rowan, J.(2001). Reich, W.(1988). MacNaughton, I.,Bentzen, M.&Jarlnaes. E.(1993).Ethical ConsiderationsinSomatic Masson, J.(1985). Marlock, G.(1996).Reich, Humanistic Psychology andtheNew Age–Part 1. Mann, E.(1987).Rajneeshism–anEvaluation. Makari, G.(2008). Svoboda, A.(2012). Reich, W.(1948/1972). Reich, W.(1933). Postle, D.(2000).Shrink-Wrapping Psychotherapy. Oakley, H.(2004). Who willremember February 11th?Bulletin oftheCollege Nitzschke, B.(2003).Psychoanalysis andNational Socialism: Banned orBrought into Miller, R.(1987). Luborsky, L,Singer, B.&Luborsky, L.(1975).Comparative studiesofpsychotherapies: is Lowen, A.(1958). London: Fourth Estate. Francisco: Jossey-Bass. London: Routledge. Brunner-Routledge. Character, 1.34 hrs(withsubtitles)www.youtube.com/watch?v=DHyeS94J7EA April, 37-47. University Press. Dryden, W. (Ed.) (1988). the Royal CollegeofPsychiatrists, Farrar, Straus &Giroux. publication: Copenhagen:Sexpol. Available on:http://ipnosis.postle.net/pages/BCPtalkshort.htm. HayaFebPaper.htm: 05/12/10. Psychoanalysis; June, 2004:Accessed onhttp://www.psychoanalysis-cpuk.org/HTML/ Conformity? Break orContinuity? Psychotherapies. pp. 995-1008. haswonandallmusthave prizes? thateveryone it true ofCharacterDynamics Structure. 27(2),1-15. Bare-Faced Messiah: ofL.Ron Hubbard. story The true Die Massenpsychologie des Faschismus Passion of Youth: Wilhelm Reich, An Autobiography, The LanguageoftheBody. Adventures intheOrgasmatron: Wilhelm Reich andtheInvention ofSex. The Assault on The Assault Truth. Ordinary Ecstasy: The DialecticsofHumanistic Psychology. Revolution inmind: The creation ofpsychoanalysis. Wer hat Angst vor isafraidWilhelm Reich? [Who of Wilhelm Reich?] Energy andCharacter,Energy Listen, Little Man. Innovative therapy inBritain Crazy Therapies: What theyare? Do theywork? New York: Grune &Stratton]. ABiography ofReich. 7(10),190-195. International Forum ofPsychoanalysis, Harmondsworth: Penguin. Harmondsworth: 24(2),38-46. New York: Farrar, Strauss &Giroux. New York: Collier[First publishedas A CriticalofJungian Dictionary Analysis. Journal ofHumanistic Psychology, Energy and Character,Energy Energy andCharacter,Energy Brtish JournalBrtish ofPsychotherapy,

[The Mass Psychology of Fascism][The Mass Psychology Psychotherapy. (178-202).Milton Keynes: Open New York: St Martin’s Press. Energy andCharacter.Energy Archives ofGeneral Psychiatry, 32, 13(2),72-76. SHADOWS INTHEHISTORY 1897-1922.New York: New York: Harper New York: Guilford Press. 18 (2),41-49. New York: Sphere. 12,98-108. 30,(4),6-21. London: Energy and and Energy The Physical Physical The 22(1), 16 (3), 16(3), San San Bulletin of Film: . Original . Original

29 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 30 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS xii xi x ix viii vii vi v iv iii ii i ENDNOTES: Zaehner, R.C.(1974). Young, C.(Ed.) (2012a). Young, C.(Ed.) (2011). Young, C.(Ed.) (2010). The History andDevelopment ofBodyPsychotherapy: European Young, C.(2008). The HistoryandDevelopment ofBodyPsychotherapy: The American Young, C.(2006b).150 Years On: The History andDevelopment ofBodyPsychotherapy www.courtenay-young.co.uk/courtenay/articles/B-PRisks_Cpt.pdf Young, C.(2006a).Risks Within BodyPsychotherapy. Published as‘Körperpsychotherapie und Westland, G.(2010).Report ofthe11thCongress oftheEuropean AssociationforBody Westland, G.(2002).Personal Reflections on Developments inBody Psychotherapy. COURTENAY YOUNG ANDGILLWESTLAND

Being aneditormyself, Idon’t oftenlikedisagreeing withothereditors,whohave their own styles,etc.andthatthere The original version of this article: “The History&Development of Body psychotherapy: “The The originalversion Part ofthisarticle: 5:‘Qui custodiet psychotherapy against witches(Oakley, isbasedonlegislationfrom the16thcentury 2004). In France, thisfearofsectsis muchmore openlyacknowledged andtherecently proposedFrench new law on UKCP: United KingdomCouncilforPsychotherapy. religious groups, doomsdaycultsand(New World Order) conspiracytheories. Christians andtheEsseneswere sects(intheirtime).In theUSA,FBI(1999)analysisfocused onapocalyptic usually refer toasmallreligious orphilosophicalgroup: butmore recently thepejorative usagehascrept in. The early Sects andcults:thisisadescriptive useofthesewords, ratherthanapejorative useofthesewords. These terms periods. of long-termabuse(about8years); theother2 for shorter sexual abuseby takingadvantage ofaconsulting,treatment, orequivalent care relationship. Two ofthevictimsspoke 249.2.3oftheDutch rapeunderArticle Penalcounts ofrepeated statutory Code§174(Criminal Code)concerning From anaccount oftheRoermond (Netherlands) records court intheprosecution ofHans Krens (14/02/2007)on4 (Edinburgh). Roehampton University, Derby University, Christchurch University, Canterbury andQueen Margaret University Masters degree Dance Movement Psychotherapy trainings currently exist at Goldsmiths (U. of London), Reich: www.gentlebio-energetics.com Gentle Bioenergetics –essentiallydeveloped from aformofmassageforpremature babies–developed by Dr. Eva USABP: United States Association ofBodyPsychotherapy: www.usabp.org EABP: European AssociationofBodyPsychotherapy: www.eabp.org Svoboda (2012). Reich wasavictimoftheFBIandformMcCarthyism; andthere filmabout isalsoanew Reich by Antonin However, Philip W. Bennet (2010,2014)iscurrently acampaign(inhisown running iconicmanner)toshow that Thich NhatHahn’s poem:‘CallMe By My True Names’ www.quietspaces.com/poemHanh.html at thede-capitisationofBodyPsychotherapy throughout thisarticle. are different editorial conventions from different sidesoftheAtlantic, butIhave toregister aslightpersonalprotest conjunction withGill Westland andthispresent isasubsequentdevelopment ofthatrevised article version. Historicalin “The Basis ofBodyPsychotherapy (Young, 2011).It wasalsoextensively rewritten anddeveloped in the seriesinJournal ofBody, Movement andDance inPsychotherapy. The originalversion wasthenpublished ipsos custodes?”[Latin: Who guards theguardians themselves?] waswrittenby Courtenay Young of wasaspart Diversity. Legacy of Wilhelm Reich. Today. 625-632). Stuttgart: Schattauer, Accessed: 23/3/13from: ihre Risiken’. In: Marlock, G.& Weiss, H.(2006). Body, Psychotherapy andthe8thInternational ScientificCommittee,8-11 November 2008, Paris. Society. Psychotherapy Publications. Psychotherapy Publications. Movement andDance inPsychotherapy, 30(1),7-16. Journal forBody, Movement &Dance inPsychotherapy, Journal ofBody, Movement andDance inPsychotherapy, Our Savage God. The Historical Basis ofBodyPsychotherapy. About theScienceofBodyPsychotherapy. Journal ofBody, Movement andDance inPsychotherapy, London:Collins. 5,(1),89-93. Handbuch derKörperpsychotherapie. 1(1),5-20. Galashiels: Body Galashiels: Body Galashiels: Body 5(1),5-20. 3 (1), 5-18. 3(1),5-18. Self and (pp. sense usedhere, itisaturningtowards theself. Obversedoes notneedtoinvalidate theothertobetrue. alsoimpliesturningtowards; inthe obverse ofobjects relations theory. An“obverse” answer isoffered here that asacounterpart origins ofthisself, asthe ofalargerwork: thecreation isthefirstpart ofaself-to-selftheory is theself-to-selfrelationship, whichisthebasisforalllaterrelationships. created existence anddevelopment. The selfisrevealed inrelationship, buttheinitialsenseofself isnot a pre-existing subjectivity to its fulfillment through such relation. There is a difference between relation isnotthecreator oftheself, of butanessentialenableronthedevelopmental trajectory the self. The formative role oftheotherisnottobedenied,merely re-defined. In this conception, own experiences.Humans are notfulfilledwithout relation; it’s essentialforthedevelopment of therapy, andelaboratestherole oftheselfindevelopment: theselfasorganizingagentofits © Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 13,Number 1,spring2014ISSN2169-4745 International BodyPsychotherapy Journal in development andpsychotherapy, there isanoveremphasis ontherole oftheother, I present twomajorself-models:selfassubjectandobject.My positionisthat with adiscussionofthecharacteristicsES. existent self. Idiscussthree themesbasictothisre-evaluation oftheself, whichIfollow toelaboratethispre-existing aprioritocontactwithothers;thisrelationship isnecessary term thatIhave created toindicateaunifiedbody/mindstatewithcoherent subjectivity resulting intheover-reliance ontheself-as-objectmodel.Iargueforanendoself(ES),a The following quotationfrom Snygg (1941)represents thetwomaintheoriesofself: The elaborationoftheconceptanendoself(ES),atermI created toemphasize theinner addressesThis article anoveremphasis ontherole oftheotherintheoriesdevelopment and Keywords: phenomenologically, fromof thebehavingorganism itself. thepoint of view It may be studied objectively, as by an outside observer, orit may be studied For from two distinctpointsofview. behavior tobestudied,itmustobserved by relationship. Subjectivity existsa A selfModelfor Body-oriented Psychotherapy? agency, self-to-selfrelations, self-referential, embodiment,Reich Received 30May 2013;acceptedDecember 2013 The Art andScienceofSomaticPraxis The EndoSelf: Will Davis Introduction Self Models priori Abstract Printing, ISSN2168-1279Online torelationship. relationship The mostimportant

THE ENDOSELF 31 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 32 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS directly attributable tocharacteristicsofthe parents” (p. 5). that muchofparental influenceisillusory” and “…precious littleinachild’s development is that we ofparents have exaggeratedtheimportance for development: adoptionstudiesshow The psychoanalyst Peter Fonagy (2002)concludedfrom twinstudies,“It isprobably true ask forherfather, butratherexpressed the unfulfilled,immutabledesire tobe “fathered”. not the “father” that is the main theme, but the experience of “I want…” The patient didn’t obverse conclusion,thattheaimofdrive istheself. In contrast toFairbairn’s position,itis patient declare, “Iwantafather”, concludedthattheaimofdrive istheobject.Iargue self isinconceivable without the object” (p. 35).Fairbairn (inBuckley, 1986),afterhearinga relationship withthetherapist.” The bodypsychotherapist Inge Krens (1999)writes,“The reiterated ataBioenergetic Congress by Tonella (1999)whenhesaid,“Existence isfoundin (Buckley, 1986)positionisthatthe baby doesn’t existwithout relationship, was andthisview dynamicthathasbeenrecognizedan important inrecent infantresearch. Winnicott’s the objectasorientationpointbutdoesnotmention thebaby turningbacktoitself, Margaret Mahler (Buckley, 1986)describedthebaby asmoving towards and away from observations. perceived shapesdevelopment, andthosechangesinturnshape andcreate theexternal modify eachother. becausehowThis relational modelisco-evolutionary theselfis socialself.studies oftheselfare basedontheexternal,observable or conceptualized, renders itelusive” (Loevinger&Blasi, 1991p.161). Asaresult, most to quantify. factthattheselfassubjectmustbelived, nottheselfasknown “The Blasi characteristicoftheselfassubjectisthatitdifficult (1991)pointout,animportant and thefocuschangesfrom thecontentofselfto the “self asknower” or“self assubject” wherein theactorandperceiver are thesame, oftheselfisbasedonexperienceorganism,contrast, thephenomenologicalview of language. This linguistic monopoly has become axiomatic” (Pagis, 2009 p. 266). In Mead argued,“cannot experiencehimselfdirectly, butonlythrough thepublicmedium to Harter, ofmirroredemphasizes theimportance socialinteractionsincreating theself. According “self asknown”. (Ryan, 1991),which Anothertermusedinthiscontextis “reflected self” andstudied. that canbeobserved This isalsowhat William James (Ryan, 1991)called WILL DAVIS The selfasobjectisa notedaboveThe objective, self-concepttheory isalsocalledselfasobject,athing An overemphasis ontheformative role oftheotherisreflected in various theories. A more recent model is the dialectic self whereby the two aspects of self and other wrong inacontingentstatus.(ascitedRyan, 2003,p.227) norms, whichistheoppositeofautonomy, aninternallybasedsenseofrightand This results ininternalized heteronomy: subjectingoneselftoanexternallaw, social the “me” ratherthanthe“I”.Relationship isbasedononeasanobjectfortheother. from theresponse oftheotherandtheseadopted opinionsformself-definition. It is One usessignificant others asasocialmirror. One gets one’s opinionaboutoneself completely contradictory. (p. 406) The factsderived fromare thesetwopointsofview non-identicalandare often An Overemphasis ontheRole oftheOther cognitive conceptbasedonlanguagewherein, “...[t]heindividual”, how itisorganized . AsLoevinger& whose uniquequalityisthatitexistsa An Endo Self psychology asfirstconceptualized by Maslow. of theselfanditsdevelopment through relationship: anendoself, aunifiedstate,andpositive Schore, 1999;Stern 1998.)Outlined below are three themesinvolved withthisre-evaluation within theinfant(Cozolino, 2002,2006;Hepner, 2002;Kouider, 2013;Mitchell, 2000; subjectivity andisausefuldescription ofanESstate: observation” (p. 413). from this field. For Syngg (1941), theloci of actionsof the behaver are “not opento outside phenomenological fieldandthelociofactionsare whatthebehaver to theselfthatistakeningestaltformulationofafigure/ground; thebackground isthe locus ofactionisthebehaver’s phenomenologicalfield” (p. 413),whichisthesameapproach determiningusually notthesamething.Syngg (1941)saidofthesubmarineanalogy:“The frombehaviors ofthesubmarinethatare theoutside,asSyngg observed (1941)noted,are to avoid areef orgoingtoodeep, etc. The internalexperienceswithinthesubmarineand conclusionsaboutit:thesubmarinehastobecareful thesubmarineandmakecertain observe never know whatisgoingonoutside. The environment onlyexistsfortheobserver. One can and Varela (1998)contendthatinsidesuchavessel, apersonwillhave experiencesbutwill hermetic qualitymentionedearlier(1998,p.135). Using theimageofasubmarine,Maturana Knowledge core, thesource ofthedesire forrelationships. 1986) incommunicadocore. The conceptofanendoselfcallsforcommunicationwiththat something deeperthantheusualsenseofselfwhichissimilarto Winnicott’s (inBuckley, not cognitive, statesexperiencedasobjectrelations. Hinshelwood (1989)arguesthatwhatare commonlycalledfantasiesby Kleiniansare body, relationship totheself.that objectrelations totheprimary Alongtheselines, are secondary are secondary” towhat? incitesthequestion,secondary The conclusionproposed here is description oftheinfant’s worldisalmost“hermetic” (p. xvii). Saying that“object relations object relations inreal importance” lifeare ofsecondary (p. xvii) andcommentsthather foraformulationofanendoself.is indeedmuchsupport cognitive andsocialpsychology, psychiatry, mindfulness,andphysics—toshow thatthere the functional level. I will refer to various fields — psychoanalysis, biology, psychotherapy, initially comes into relationship with objects/others. It can be contacted and worked with on within thephenomenologicalandorganismictheoriesofself:selfassubject/knower. It iswhat The endoself(ES)isanearly, self-organizing,unified,embodied,coherent senseofself There isamovement withinpsychology towards are-evaluation ofanearliersenseself Abraham Maslow’s (1968) “being state” continues this description of a profound, internal In biology, Maturana and Varela’s books Guntrip’s (inBuckley, 1986)“innercore ofselfhood” (p.466) impliesthatthere is For example,Buckley (1986)quotesMelanie Klein:“…theexperiencesofthechild’s absorption. Afigure becomesall figure andthe ground disappears. (p. 74-75) from purpose.Asifthatwere allthere wasin theuniverse; there isasenseofcomplete Being statesare awhole,detachedfrom relations, from usefulness,expediency, and (1998) describe the nervous systemascharacterized by “operational (1998)describethenervous closure”, the Three Themes priori Autopoiesis andCognition tocontactwiththe“other”. The ESisbased chooses (1972)and tocreate asfigure THE ENDOSELF The Treeof 33 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 34 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS probably makes constant predictions about the environment in anticipation of paltry sensory probably makes constant predictions sensory about the environment in anticipation of paltry findings suggestedthatthebrain only 10,000bits persecondmakeittothevisual cortex…The system:“Ofinput reaches 10billionbitspersecondthatarrive ontheretina… thecentralnervous organizes memories and internal systems. Raichle (2010) points out that little external sensory external event” (Raichle,2010p. 31).Raichle(2010)suggeststhatitmay bethewaybrain only 5%,while“60to80%of allenergyusedby thebrainoccursincircuits unrelated toany when thebrainresponds consciously. Engaging inconsciousactivityincreases energyconsumption actuality thebrainnetworking withitselfandconsuming 20timesmore energythanisutilized back anddoingnothing” (p. 28). What wasoriginallythoughttobe“background noise” isin relationship: “A great activity isoccurringinthebrainwhenapersonsitting dealofmeaningful there mustexistanorganizingagentfunctioning speaks ofabrainthat“matures” intoa“relational organ”. Fuchs (2009)writes: (p. 41)andare “…predesigned toseekoutandengageinlearningopportunities” (p. 46). of languageandinterpersonaldiscourse.Stern (1998)pointsoutthatinfants“seek stimulation” revealed by the factthatitisseekingcontactwithanexternalenvironment before theexperience (p. 214).Anascentcore theideathatthere ofselfsupports isasubjectivity nascent core ofself” from infancyevidencedby activitytogetenvironmental responses. This suggestsfrom infancya psychologist Ryan (1991)whorefers tothebasicdrives asintrinsicmotivation that“...ispresent being dependentondirect socialinteraction” (p. 277). Alsorepresenting thisshiftisthecognitive (2009) hasreached theconclusionthat“[t]heactualrepresentation oftheselfisnolongerseenas a baby withoutthemother. But thismodelisbeginningtoshift.Similar totheESconcept,Pagis (p. 277). This recalls Winnicott: withouttheotherselfdoesn’t exist;there isnosuchthingas (in Pagis, 2009)wrote, “One inevitablyseeksanaudience,hastopourhimselfoutsomebody” known, whichdevelops from language,discourse,anddiscussionwithothersoneself. Mead Maslow’s (1968)description. translate tobeingdeeplyrelaxed, withinoneself, secure, andself-accepting,allofwhichreflect threshold, andlowered levels. rateandcortisol heart These measurablephysiologicalresponses in laborandbreastfeeding, increased digestion,more movement, betterlearning,ahigherpain Uvnäs-Moberg (2004), described the state of high levels of oxytocin: smooth muscle activation initsown andanobserver experience. participant (Mitchell, 2000, p. 42). As a result, the endo self is the object of its own subjectivity, both a WILL DAVIS An earlysenseofselfisincontrastwithcognitive andsocialpsychology’s conceptoftheselfas The ESand“beingstates” are related tosignsofhighoxytocin levels. At anEABPCongress, Loewald’s unitofexperiencemight‘bestbedescribedasbeing’” agrees: “…theprimary This speaksofa“mind” before thebrainisinvolved; before therealization ofrelationship, Similarly, distinguishesbetween theembodimentconceptinpsychiatry mindandbrain, Marcus forthisstateof an organizingagentpreparing Raichle(2010)offerssupport for processes ofconsciousexperience.(p. 573) ascarrier ofembodiedinteractionsthatthepatterns ofbrainactivitycanserve as apart situation, thusfunctionallyconnectingorganismandenvironment. However, itisonly dispositions maythenbe neuronal circuits andexcitation patterns. experienced intheseinteractionscometobesedimentedtheorganismformof the brainmatures anddevelops intoa‘relational organ.’ The relationships andmeanings From itis mainlythrough ourembodiedinteractionwiththeworldandothersthat birth, actualized [emphasisadded]inaccordance withthepresent in order tobe Once developed inrelationship. [emphasis added], these organic [emphasisadded],theseorganic his introduction to of subjectivityfrom themomentofconception. This ideaisechoedby Sir Stafford Beers (1972)in suggests thatwithexistencecomesconsciousness(p.10, p. 40).For humans, there isthepossibility Universe, “I don’t getolder;Iwanttodance;am untouchable,notinfluenced by others,solid”. Anothercommented: One patient’s instroke experiencewas:“Ihadanappointmentwithmyself”. instroke creates distanceanddifferentiation butnot,ascontractiondoes,isolationandseparation. withit.Itinterfering isexergonic, energy-freeing, andresults inamovement towards theself. The The instroke isagathering,centripetalmovement inward thatcreates experienceratherthen moments, thestatesdescribedwithhighoxytocin levels, sleeping,orMaslow’s (1967)beingstate inward are avoidant orcontractive (Davis, 1999a&b).Deep spiritualexperiences,reflective negative experience.But theinstroke isdifferentiated from contractionbecausenotallmovements his instroke concept.It thattheorganismdoescontractinfearandpainawayfrom a istrue and contraction,Ihave takenKelley’s (2004)modelofoutstroke andinstroke, andelaborated and usedthedisturbanceofthisnaturalrhythmasindicationdysfunction.Instead ofexpansion andbackagain.Hethe periphery referred toitasexpansioninpleasure andcontractioninfear, 1989; 1999a;1999b;2000).Reich’s (1967)conceptofpulsationdescribesthemovement outto concept ofthe“instroke” hasresulted inasystematicwaytoelicitdeepself-state(Davis, 1984; inputs reaching itfrom theoutsideworld” (p. 31). 1 andyet itstillhasasenseofself.cortex, other creatures, includingoctopuses,alsopossessthese neurological substrates. that generateconsciousness.Nonhuman animals,includingallmammals andbirds, andmany weight ofevidenceindicatesthathumansare notuniqueinpossessingtheneurological substrates of consciousstatesalongwiththecapacitytoexhibitintentional behaviors.Consequently, the human animalshave theneuroanatomical, neurochemical, andneurophysiological substrates preclude anorganismfrom experiencingaffective states.Convergent evidenceindicatesthatnon- doesnotappearto on Consciousness,we absenceofaneocortex declared thefollowing: ‘The being evidentininsectsandcephalopodmollusks(e.g.,octopus). At theCambridgeConference sleep, anddecision-making appeartohave ariseninevolution radiation, asearlytheinvertebrate Furthermore, behavioral/electrophysiological neuralcircuits statesofattentiveness, thatsupport Young retain humanandnonhumananimalswithoutneocortices thesebrain-mindfunctions. associated withaffectare regions concentratedinsubcortical where neuralhomologiesabound. emphasizing thatfetalandinfantaffectstatesconsciousnessarisemuchearlierthanthought. (p.v). Fritz Perls (1972)suggestedthatawareness ofmatter. wasaproperty nature oflivingsystems. the very They are sayingthatifyou are living,you have consciousness” are examplesofnon-contractive inward movements

The Cambridge Declaration on Consciousness was written by Philip Low and edited by Jaak Panksepp, Diana Reiss, was signedby theconference inthepresence participants, ofStephen Hawking. non-Human Animals,atChurchill College,University ofCambridge,by Low, Edelman andKoch. The Declaration in Cambridge,UK, on July 7,2012, at the Francis Crick Memorial Conference onConsciousness in Human and David Edelman, Bruno Van Swinderen, Philip Low and Christof Koch. The Declaration It was publicly proclaimed Surprisingly, research theconceptofES.In inphysicssupports In the body psychotherapy branch of Functional Analysis, the development of the pulsatory This istoclaimthatthere issubjectivitybefore activity. cortical Amagpiebird hasno structures. The neuralsubstratesofemotionsdonotappeartobeconfinedcortical Systems Additionally, in2012,theCambridgeConference onConsciousnessissuedadeclaration Jantsch (1979)comesdirectly tothepointaboutwhatIcallanendoselfwhenhe Autopoiesis andCognition: “They define cognition as a biological phenomena; definecognitionasabiologicalphenomena; “They towards somethingdeeper:theendoself. The Self-Organizing 1

THE ENDOSELF 35 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 36 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS of asplitbetween thebody andmind. on thedetermining, creative forces ofthesubjective self. It furthermore overturns theperception oftheobjectanditsrepresentationsshifting theemphasisfrom theimportance toanemphasis systems resulting ina“recorporalization ofcognition” ((Fuchs, 2009p. 570). of embodimentwiththeconvergence ofphenomenology, cognitive science,anddynamic the sametime. 2009 p. 268).Somatic self-consciousnessissomato-psychic, originatinginbothrealms at is a symbolizing process that takes place through a require conceptualizationorverbalization“Somatic tobemeaningful. self-consciousness cognition’” (p. 828).Further, Pagis typesofexperiencesdonot (2009)reports thatcertain systemsandare grounded intheirphysicalcontext. the sensory-motor There is‘embodied &KooleSchubert (2009)write“…socialconceptsare processed incloseinteractionwith psychology, where typicallytheselfisrooted insocialinteraction,cognition,andlanguage. differentiations andstructures thatdevelop through interactionwiththeenvironment. density” istheoriginalsubjective state. The distinctionsandboundariesare thelaterpsychic hereLoewald isreferring tothetraditionalpsychological conceptofasocialself.) This “primal are superimposedupon this primal density” (as cited in Mitchell, 2000, p. 39). (By “self”, in termsof…aprimaldensity. Alldistinctionsandboundarieswhichwe are familiarwith drives, noself, noothers,now, nothen,external,internal.Everything isexperienced primal density where: “…experience begins in an undifferentiated state; there are no objects, no “physical body;itisinthe‘ state when he said that what he was feeling was in the this body morebut not in the primary all three istheunchanging,unifiedsource of themolecular arrangement.Apatient referred to Depending onitsenergeticstate,itcanfunctionindifferent manifestations,butunderlying things, butwe know thatonamolecular level theyare three formsof thesamething,H²O. can be modeled by our understanding of ice, steam, and water. They seem like three different sense of subjectivity. The conceptofa “dual/unity”, touse Mahler’s (in Buckley, 1986)phrase, more differentiated psychic and articulated structures and functions develop out of this earliest mind, differentiated referred butindivisible.Descartes tothisasthe mind split. The tworealms ofpsyche andsomaemergefrom thisearly, unifiedstateofbody/ exists A Unified State WILL DAVIS Similar totheexperienceofanarchaic body, thepsychoanalyst Hans describesa Loewald This elaborationofearlystatesconsciousnessbringsustoournexttheme:theendoself I understand this discussion on the change from representationalism to the lived body as This shiftingparadigmtowards aunifiedbody/mindstateisalsoseeninpsychiatry’s theme There isashiftingparadigmtowards aunifiedbody/mindstateincognitive andsocial before an innerrepresentation thatmirror theoutsideworld approaches tocognitive neuroscience inorder toovercome the the lived body(p. 574).“A phenomenologyofembodiment maybecombinedwithenactive embodied andenactive concepts ofcognitive neuroscience thatare incorrespondence with existence. So insteadofrepresentationalism, withitsfixed inside-outside distinction, we need enmeshed intheworldwhichwe move, behave, andlive with others through ourbodily the other hand, the neuro-cognitive system cannot be grasped separately; it exists only as concepts ofthemindasaninnerrealm ofrepresentations thatmirror theoutsideworld.On On theonehand,phenomenologyoflived bodyisabletoovercome thedualistic the development ofpsyche andsoma.It isanorganismicself, preceding thebody/ archaic body’”. nonverbal, embodied medium” [emphasis added]”(Fuchs, 2009p. 571). dualist concepts of the mind as dualist conceptsofthemindas conarium. Allofthelater, (Pagis, terminology that emphasize the self’s deficits: tabula rasa, autistic, normal autism, narcissistic, deficits:tabula rasa, autistic, normal autism, narcissistic, terminology that emphasize the self’s Maslow’s Positive Psychology (Totton,physiology withanaimatunifiedbody/mindfunctioning 2014 p.3). robots shouldbemore an“up hierarchy” whereby feelings,thoughtsandbeliefsare rooted in motor system experiences, what Reich called “man’s roots in nature”. Therefore, building Anderson (inDavis 2013)arguesthattheabilitytosymbolize developed outofearliersensory- model ofthebrain’s abilitytosymbolize necessarilyposesalimitationtorobotic development of embodimentinrobotics (Anderson,2003). The top-down ofdevelopment view basedonthe self-regulate. subjective experienceandits abilitytoself-organize and psychology emphasizingtheendoself’s a shift from an overemphasis on lack, pathology, and dysfunction to a resource-based, positive development isalways beingdone“by someone” (Ryan, 1991, p. 212). This paper arguesfor on Piaget’s developmental stagesandarguesthatthepassage through “inherent structures” during responses. It has subjectivity, knows what it wants, and is in contact with reality. He also comments order, suggestingthatwithintheinfantthere isself-organizationandcoherency. ego, alogical,socialsystemorientedtowards relationship anddevelopment. From disorder comes that theidischaotic,incoherent, andeven destructive. Yet, outofthisdangerous chaosarisesthe always reality-oriented” (Heller, 2009).Even Freud His canbecalleduponforsupport. positionis (personalcommunication,November,a more reality-oriented self” 2009).For Heller, “Lifeis understood that“…theinfant’s earlypsychic structure iseventually replaced orsupersededby subjectivity withwhichtoorganize thisdifficulttask. easy from there toconceive thatthere mustexistadeveloped, coherent, stablesenseofagency/ comes from Kohut (2001),whoarguesthatinafragmentedstate,theinfantmastersreality. It is arises from thisis:whomisthemothercommunicatingwithandviceversa? Anotherexample body-oriented), emotionalcommunicationsystembetween motherandbaby. The questionthat identification andprojective identificationwhichdescribeanunconscious(forSchore(1999), consciousness, andcoherency, at thesametimemanytheoristsargueforconceptsofprimary confront issuesofinfantconsciousnessinrelation toanesthesia,pain,andpathologies” (p. 380). found inadultscanbegeneralized toinfantpopulations…and[this]mighthelppediatricians anesthesia” (p. 266).AsKouider (2013)pointsout,however, “…neuralmarkers ofconsciousness 75%ofcircumcisions are without Cozolino performed (2002)writesthat“intothe21stcentury without anestheticbecausetheywere deniedpsychological lifeandpainsensitivity” (p.6). Janus babies wascarriedoutonnewborn (1997)pointsoutthatuntilthe1980s,“…surgery not existinguntilthedevelopment oflanguage,allcontinuethisorientationdeficiency. proto self, Kohut’s (2001)fragmentedself, Stern’s (1998)emergentself, andLacan’s (1997)self “positive psychology”. Shore’s (2006)implicitself, Ryan’s (2003)nascentself, Damasio’s (2000) pathology, dysfunction,andlack.In turn,heemphasized the need forthedevelopment ofa and destructive. This iswhatMaslow (1968)calls“deficiency psychology”, overemphasizing disorientation,primitive, pre-reflective,in astateofprimitive hallucinatory andtheidaschaotic A third reason fortheformulationofendoselfisoveruse ofnegative development From anentirely different forthedevelopment perspective, oftheconcept thesameistrue As Ryan (1991)pointedoutearlier, is seeking environmental the“nascent core ofself” This isthepositionofbodypsychotherapist Michel Heller who wrote thatitisclassically It isinteresting thatwhiledeficiencymodelformulationsindicatea lackofcohesion, The formulation of a non-existentselfor a deficiency state oftheself has serious repercussions. THE ENDOSELF 37 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 38 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS not theselfconcept. The selfisnotacollection ofselfschemas” (p.150). Syngg (1941)similarly model by describing theselfas“…something accessibleinthe1stinstanceonly toitself. This is the firstline. She didn’t automaticallybelieve hertrainer, she referred toherselffirst. have tothinkabout it.”Ipointedoutthatwhatshewasdoingself-referential behaviorin with whichonewoman did notagree. After we forawhile shesaid,“Iwill went backandforth negative andthenacts. In atraininggroup Iwasexplainingtheconceptofself-referentiality, contactwithitsenvironment; itcontinuallyevaluates experienceaspositive or pulsatory “hermetic” thatwasusedearlier, whichhasanegative quality. Every systemisinintermittent, makes constantpredictions abouttheenvironment with“paltry” input. sensory hearing aname. This follows withtheconclusion,reached by Raichle(2010),thatthebrain unremembered” (p. 130). We have decidedifwe likeapersoneven before shakinghandsor reaction before we are consciousofwhatisbeingprocessed. He callsthis the“known and points outthatthespeedofamygdalainprocessing informationgeneratesaphysiological memories thatshapeouremotionalexperiences,self-image, decisions,andrelationships. He Cozolino (2006),thevast majorityofmemories are unconscious(pre-cortical), anditisthese that we are alwaysmakingdecisionsonapre-cortical level withoutawareness. According to unconscious decisions,andbrainscanresearch, aswell astheCambridgeDeclaration, shows in termsofapproach/avoidance orattraction/repulsion. In psychological termstheseare caring foryou?” He replied, “Me.” becauseIrealized InowI stoppedcrying is have someonewhocares forme.”Iasked,“Who the past.Apatientsaid,“On thewayhere toseeyou Icriedthewholehourincar, butthen moment, self-referential comments, and less about others andwhat had happened to them in Self-Referential intheFirst Line a clearself-to-selfrelationship. are allinstroke-oriented, endo-selffunctions. Therefore, source forrelationships is theprimary preconditions for relationship, asenseofself, well-developed borders, clear differentiation etc., at the2ndEuropean Bioenergetic Congress onembodied relations in1999,Iarguedthatthe origin inthisoriginal, unified stateofbody/mind creating all relationships. In apaperpresented etc. (For anadditionallisting,seeDavis, 2006).Allimpulses,inward andoutward, have their developmental terminology:incorporation,introjection, assimilation,insight,internalization, of theseistheinstroke, thereturn totheself. The classicalliterature isfullofinstroke-oriented of allinteractionswiththeexternalenvironment aswell as The Primary Source WILL DAVIS The ESisthesource ofalldrives, desires, dreams, motivations andmovements. It istheorigin The socialpsychologists LoevingerandBlasi (1991) mirror Jantsch’s (1979)self-referential “Self-referential” maybeamore usefulexpression fordescribingexperience than the For Jantsch, (1979)allsystemsare self-referential inthefirstline. Thisiseasilyunderstood I becameinterested intheendoselfconceptwhenmypatientsbegantoreport more present us.(Robinson, 2010p. 1). and for and despite, and that, often enough, we die from. Nothing is more essential to other ways than we know, thecreator of thereality that we live within, that we live by The mind,whatever elseitis,isaconstantofeveryone’s experience,and,inmore and Characteristics ofanEndo Self interactions withitself, andthedeepest and Cognition,Beers (1972)emphasizes that: terms, selfassubject). They prefer the“self-referred” model.In hisintroduction toAutopoiesis referred” terms,selfasobject)and“self-referred” states(inselftheory states(inselftheory that substantiateone’s own views” (p. 412). behaver” (p.411).Syngg (1941)goesontopointoutthereader isprobably “…selectingparts direction and degree of differentiation are determined by the phenomenological needs of the tothephenomenologicalfieldofbehavingorganism. by andpertinent More specifically, the emphasizes theselfasoriginatorofits own experience. “Behavior iscompletely determined At the sametime,there isa “me” andanot“me” (Eagle,1991,p.55). For Eagle(1991), Eagle’s analogyistosaythatitasiftheperson hasapieceofplasticembeddedwithin. unacceptable mental contents are repressed, relegated to other “selves” or the impersonal “it”. individual by excluding threats by dangerous content. In theclassical drive/conflict model, are basedonthesplitting process. In the thedeficitsmodel,disassociationasastrategyserves or drive/conflict —one stillworks withthesame problem because functionally boththeories whichever ofthetwo major developmental theories onemayadhere to—defects/deficits/lack system cannotviolatetheprincipleofitsexistence” (p. 21). another beinginorder Insightfully, tosurvive. thebiologist Voeikov (1991)states,“…aliving sense oftheself, sotheymust besplitoffby “jumpingout” behaviorsorbeingprojected onto and in projective identification. The contents cannot betolerated within thepoorly developed manifests mostevidentlyinthesplittingoffbehaviorsofborderline personalitydisorder case integrate the“good mother” andthe“badmother”. In theadultstate,aninabilitytointegrate splitting” is normal and healthy in children because, for example, they cognitively cannot yet costs” (2006,p. 206). Cozolino callsit“the needtoescapeanunbearableself”,“…aassomething to avoid atall from astatethatcannotbeintegratedandwhichthreatens theintegrityoforganism. multiple personalitydisorders, andactive expulsion.Allare anattemptby theselftoseparate disassociation, merging,fusion,symbiosis,psychosis, fractionation,splittingofmentalizations, resistances, compensations,adapting,projection, projective identification,intellectualizing, splitting, disassociation,fragmenting,decomposition,repression, armoring,avoidance, denial, illustrates thedesperatebehaviorsorganismwillengageintoavoid danger:schizoid existence. Paradoxically, people split offtostay whole. The following incomplete list of defenses despitealldysfunction,thepersonwantstostayinworld. will tosurvive; tostayinexistence. will dowhatever isnecessary The hopeofpsychotherapy isbasedonthis All Systems Abhor Splitting The biologistsMaturana and Varela usingtheterms“allo- (1972)takethesameview In In More specifically, Kernberg (1984,ascitedinSchore, 1991)pointsoutthat “primitive Defense isafunctionalattempt,nomatterhow “illogical”, tokeeptheorganismin A correlate oftheideaself-referentiality isthe principlethatlikeallothersystems,theES Developmental Defects Versus Conflict Dynamic as they are objects of observation and as description, they arenor even as interacting systems, but objectsof observation Theirs isasystematictheoretical biologywhichattemptstodefinelivingsystemsnot referential andhasno‘outside’. (p. v) radically still,onewhichfrom ‘the pointofview’ ofthesystemitself, isentirely self- autopoietic systems…moreself referring closed systems – in short and self constructing self-contained unitieswhoseonlyreference istothemselves. …theyare autonomous, , Morris Eagle(1987)emphasizes that THE ENDOSELF 39 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 40 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS development andtherapy. whereby bothsystemsare altered by the contact, we canthen modelthedialecticposition of If we incorporateintothisJantsch’s (1979)modelofco-evolution between interacting systems “pumped into” theinanimatesystem. matter andenergy, whereas inasimilarprocess. theinanimateisapassive Energy participant is ofthesystem. forthepreservation metabolism isnecessary The livingsystem Metabolism innon-livingsystemsusuallyresults inthe“death” ofthesystem.In theliving, baby willmanipulatethemothertoseethatitsneeds are met. to getwhatitwants.Infant research thisunderstanding,goingsofarastosaythatthe supports physicist’s representation ofRyan’s nascentselfthatwill“seek environmental responses” inorder (1977) pointsoutthateven chemicalreactions have “more thanonesolution” (p. 3). This isa the environment formore inputinorder tokeepreacting inorder notto“die” (p. 7).Prigogine “hyper-cycle” showing how non-livingenergy systems,suchaschemicalreactions, will“search” just a living system dynamic but a law of nature. Eigen (in Jantsch, 1979) has modeled the Prigogine (1977),Jantsch (1979)andthebiologist Voeikov (1999).Self-preservation isnot extended intotheinanimaterealm by theworks ofthephysicistsEigen (inJantsch, 1979), endo self. For process oflifehasbeen astheprimary ofself-preservation example,theview life process. For thisreason, Ifind research inphysicsandbiology relevant todelineatingan tounderstandsome ofthebasiclawsnature, especiallythosegoverningit isnecessary the month oflife,there isan“ego instinct towards self-preservation” (p. 201). with aninherent senseofself-integrity, Mahler (Buckley 1986)pointedoutthatwithinthefirst unaware of or reject, with emotion, data inconsistent with our own beliefs” (p. 413). Consistent the phenomenologicalfieldandself—thusourtendencyto remain needs inaphenomenologicalsystemare oftheorganization&integrity thepreservation importantly, the“all-important” (Eagle,1991p. aimofintegrityandunityisfrustrated 7). model. Not onlydoesunresolved conflict result infailure toexperiencesatisfaction,butmore diminished self, but a loss of self-cohesion. He for the conflict points out that the same is true argues thateven thoughdisassociationleadstoself-diminishing,themainthemeisnot (Eagle,1987,p. 9), amaintenanceofitsexistence. Takingof theself” adeficitsposition,Eagle diagnosis” (1991,p. 6). continuity ofselforganizationisasupraordinate aimforallpeopleindependentoftheir Eagle refers tothewritingsofGedo &Kleintoelaboratehispoint“…theintegrityand is usuallynotenough.It remains splitoff, placed to theintellectualsphere. He pointsoutthat simply makingunconsciousmaterialconscious intellectualizing isaformofsplitting:psychonoetism, thetransference of personalconflicts WILL DAVIS This isanexcellent modelingofbothrelationship and thegatheringforce of theinstroke. Voeikov from it. a biologicalperspective (1999)makesasimilar observation and furthers tocomegripswiththeearliestsenseofexistence,consciousness, In termsoftrying Surprisingly, Syngg’s isthesame asEagle’s: (1941)phenomenologicalview “Fundamental No matterwhattheoretical stanceonetakes,thefirsttaskfor organismis “sheer intactness stock to seldom burns out the fuel extracted from the environment. Rather it builds up its energy it destroys thestructures ittouchesandnever creates ones.Afire new diesbutalivingsystem oftheimpulse/input exceeds theenergy theamountofenergyreleasedas arule, asaresult ofanexternalstimulusorimpulse thatusuallytheanimateobjectis“triggered”While itistrue by anexternalstimuliorimpulse, prolong itsexistence [emphasis added].(Voeikov, 1999p. 19) [emphasisadded].Afire maybetriggered by aspark but alongside oftheacceptablecontent. actively consumes greatly greatly “born” inanon-equilibriumstate.Alivingsystemisoutofbalancewithitsenvironment in equilibrium. It work againstequilibrium….”(Voeikov, continuallyperforms 1999p.17) It is the Second Lawof Thermodynamics whenhepoints outthat“[n]olivingsystemisever at characterizes thelivingsystembeliesreductionist view” (p. 21).He leadsusbeyond entropy thatwillresult orsystem“death” ininertia (p. 21).“Stable non-equilibriumthat order: over structuralization time. states thatentropy isameasure ofdisorder (p. 4).Lifeisamovement awayfrom disorder to linear structures —thatistosay, livingsystems. They are entropy-negative. Boltzmann’s Law law ofthermodynamicsisovercome andself-regulating, by self-starting non-equilibrium,non- competence as autopoiesis (p. 209). (p. 43). The socialpsychologist Ryan (1991)seesthe developmental needforautonomyand beings …are continually self-producing”, definingthemas“…an energetic conceptthatismirrored inMaturana and Varela’s (1998)“proposition thatliving directional tendency” towards development intheuniverse. This isalsoabasicReichian andself-organizing. CarlRogersES isautopoietic:self-starting (1978)postulated“a formative Autopoietic (1999) have pointedout. therefore overcomes theSecond Lawof Thermodynamics asPrigogine (1977)and Voeikov is thatorgoneenergymoves from lower tohigherconcentrations;itisnegatively entropic and a systemisformed, it “abhors” splitting,and will dowhatever itcanto stay whole. The second over developed illusions” (Taylor, etal,p.11). of threat” (p. 252),andthat“…peoplewithnoillusionsare justasmaladaptive asthosewith tempered by realism are inmaintainingtheintegrityofself theface criticallyimportant threat. In their work withcancerandAIDSpatients,theyconcludedthat“[p]ositive illusions that thesplittingoffin“creative illusions” forgoodmentalhealthinthefaceof isnecessary Typically, splittingisseenasamanifestationofdeeperproblem. These authorsconclude threatening events canhave by creating “positive illusions” withintheperson(p. 239). take splittinginanoppositedirection. They pointouttheparadoxical positive effectsthat Jantsch, 1999),Prigogine (1977),Jantsch (1979), and Voeikov (1999). balance” are thesameasnon-equilibrium andnon-linear“survival” modelsofEigen (in ofnon-linearprocess”the start (OPD Task Force, 2001, p. 41). The “dynamics ofhomeostatic resembles asystemstressing dynamicsofhomeostaticbalanceintermsrecursive and rules constitute asetofinformationthatinturnorganizes experiencesandprocesses them. This therapy, theOperationalized Psychodynamic Diagnostics systemseesthatpsychic “…structure stay inexistenceanddoesthisby theself-centered, centripetal,gatheringforce oftheinstroke. nature theideathatalivingsystem’s supporting “supraordinate bottomline,theself’s aim”, isto point ofthisdiscussionisthatthere are now recognized understoodlawsof andatleastpartially of Thermodynamics demands. Vernadsky callsthis“the mainlawoflife” (Voeikov, p. 20). The that itdoesnotmove from ahigherorder oforganizationtoalower one,astheSecond Law Voeikov, notto“slide” (1999)statesthatlivingsystemsdowhatever isnecessary into Prigogine’s development (1979)revolutionary ofdissipative structures shows how thesecond A fourth characteristic oftheESisanextensionnegative entropicA fourth discussion. The The themeofsplittingrefers totwoofReich’s (1950)energyconcepts. The firstisthatonce Earlier Ioffered alistofsplitting-offbehaviors. Taylor, Kemeny, Reed, Aspinwall(1989) Based onphysicists’ understandingofthelawslivingsystems,butinlanguage autopoietic organization THE ENDOSELF ” 41 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 42 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS right brain-based emotionalcontactwiththe environment. He ispointingoutthatdesire phenomenon” (Schore, 1999p. 14).Interactive regulation isthebasis ofdevelopment: a definite, seeminglyinaudible, urgentappealforinteractive regulation. Thisisa“lifelong within thepatient’s oftenvociferous communicationof the deregulated stateisalsoa has thesameroot. tomoveit from trying towards forward completionandsatisfaction. Freud’s sublimation (1950) energyconceptsformulate,you caninterfere withdevelopment, butyou cannotstop (p. xvii). The conceptoftheESisbuiltoninfant’s inexorable development. AsReich’s the internalmentalworldofinfant. This internal worldhasaninexorable development” Immutability the ESformulatesagencymuchearlierthanStern. pointtheinfant’shaving asitsstarting inferred subjective experience. developmental organizingprinciple”sense ofselfasaprimary (p.26)andthisagencyas can tostayunified. perceived threats. The infantknows itisthreatened by theotheranddoeswhatever it regulating behaviorsarisespontaneouslyfrom imago into its narcissistic sense of itself. These self-referential, self-organizing, and self- or fleetheobject,soitmastersitsenvironment by incorporatingandmergingtheparent the infantcannotbearexistenceofanythingoutsideitselfandistooweak todestroy wherein theinfantmustmasterreality. In Kohut’s conception,thenarcissistic stateof individualization process tolearnbeautonomous self-regulating. It learnsattachmentandbondinglatergoesthrough aseparation/ self-organizing,andThe infantisautonomousinthesenseofagency;itself-starting, in theclassicalsenseofautonomyarisingfrom theseparation/individualizationprocess. organism. Ryan (1991)states: lifeneedsofthe thenecessary context, theESisseenasteleorganic,capableofserving Self-Regulation WILL DAVIS In thecontextofES,autonomyisseenasaninnatecharacteristic.It isnotused Self-regulation is closely tied to autopoiesis and themes ofself-organization.In this Schore’s (1999)projective identification emphasizes thisimmutability. “Embedded Buckley (1986)suggests,“In somesense,Klein’s istheultimatedepthpsychology within Stern isnotuniqueinthisview. However, of whiletheprincipleissame,theory Self asorganizingagentisalsoathemeforDaniel Stern (1998).He describesthe“… Kohut (2001)inappropriately refers toself-regulation from adeficiencymodel unique inthatrespect. (p. 26) and-other, placetheinfant’s hasasitsstarting inferred subjective experience.It is organizingprinciple. the primary This account,centeringonthesenseofself- libidinal oregodevelopment. Those theoristsnever considered thesenseofselfas the experience of the self-and-other, but mainly as the to,fall out of, or secondary MahlerCertainly andKleintheotherobjectrelations schoolhave focusedon then itisdescribedasself-regulated orautonomous.(p. 212) addition, totheextentthatactionbecomesregulated through theselforganization, functions,values,the structure towhichnew andpropensities are integrated.In an organismicperspective, theself. The selfisboththeagentthatintegratesand The locusofinitiationandspontaneousengagementwiththesurround is,from within within theinfant’s psyche inthefaceof thestateofrelatedness. search forexternalidealfigures” (Kohut, 2001 p. 62),and “…the narcissistic stream of the finalization of the idealization process results in the fact that “the person will forever the continualseekingofsatisfactionisinallrelationships. object intheanalystbothtransference relationship andreal life.He pointsoutthat basis ofmentalhealth(Buckley, 1986,p. 447).In itsabsence,thepatientfindsagood Guntrip’s dualnature oftransference (Buckley, 1986).For Guntrip, agoodobjectisthe the original,inexorable pushforsatisfyingdevelopmental relationships throughout life. “audible” (p. behaviorsremains 14).But anddistorting embeddedwithinthosedistorted for contactcanbeinterfered with,resulting in“the deregulated state” andbecomingbarely towards health. This isthehope ofpsychotherapy. behaviorsis anunaltered, anddistorting immutable streamtransformed, distorted flowing being sought.It isapsychodynamic modeloftheice,steamandwateranalogy. Below the not aboutwhathappened,but whatdidnothappenandismissingthat still and relationship: thedesire tobothgive andget love. For Perls (1972),transference is repression, sublimations andexpulsionsistheundamageddesire forcontact, regulation aim” ofunity. holdsthatembeddedwithin thedysfunctionalstatesofThe EStheory out, causedisregulation the“supraordiante anddisorganizationinthesystemdisrupt expulsion, etc.If not,there willbedeep, unresolved conflictsthatwill,asEagle(1987)points nature now thatIalwayswantedtobesomebody”. dysfunction. After an experience of an endo self state, a patient summed this up: “I realize continue totransformintothenextphaseofdevelopment; itisembeddedinhealthand this innate,immutablepushtowards development andsatisfactionwillspontaneously immutable qualityofexistence.AsKohut’s narcissistic stream showed, even whensatisfied, objects, idealized objects, transference, and all splitting behaviors — is a result of the duality ofthetransformedstate—informsublimation, substituteobjects,transitory referentialiaty, self-organization,self-regulation, andthedesire tostayinexistence. The in existence. This functioningrepresents thecombinedthemesofimmutability, self- continues toseeksatisfactionwithinthedualityoftransformationinorder tostay tobeintegrated. stop theorganismfrom trying Reich’s thatonecaninterfere withintegrative energeticmodelassertion capacitybutnever and decisive influenceonsomethingascomplexintegrative capacity” (p. 16). He takes foridealization—wouldhave adeterminative opportunities experiences or(failures of) set of early experiences — whether consisting of failuresthat a particular of empathetic life intheformoflove, creativity, wisdom,andself-value. stream seekssatisfaction,andeven whensatisfied, itinexorably continuestoflow through and realistic structures” (Kohut, 2001,p. 109).Kohut’s positionisthatthenarcissistic added] pieceoftheold,limitlessnarcissism functionsactively alongsidethenew, tamed “[o]ur ultimategoalsandpurposeourselfesteem…betraythatan (Kohut, originalnarcissism istheprecursor ofobjectlove” 2001,p.40).“The (p. 107)and the infantcontinuesthroughout lifeandisthebasisofcreativity, wisdomandselfesteem” Kohut (2001)refers tothe immutability as the “narcissistic stream”. A disturbance in All transferential behaviorsare basedonthisimmutabilityandisrepresented in In theconflictmodel, personhasmentalcontentand emotionsthatare When the developmental task is unsatisfied,it spontaneouslytransforms itselfand whenhecriticizes thedeficitsmodel;“…itisunlikelyThe Eagle(1987)joinsthischorus repugnant tohim/herandmustbedealtwithby repression, sublimation, active unaltered THE ENDOSELF [emphasis by their 43 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 44 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS (Fuchs, 2009,p. 572). There isa“…pathologicalexplication ofimplicitbodilyfunctions spectators of their own perceptive I did like a film camera’” process: “‘I saw everything even actsofperceiving itselfmaycometoawareness. Then thepatients are likethe feeling threatened. (See also thecaseinDavis, 2013.) felt safeandsecure, shecould experiencethetraumafrom theundamagedselfstatewithout is anexampleofthesecurityand well beingonehaswhenintheendoselfstate. Because she moreher for a few years and heard nothing to indicate that it was notfinallyfinished. This observer. She commented thatshefeltthistimeitwas“finished”. Iwasincontactwith happening toher, butshehadnopanic.She wastheobjectofhersubjectivity, aparticipant palpitations. Shedizziness or heart “watched it” butwasnot split off from it.It was Yet thistimethere wasnotraumaticmentalimagesorvegetative signs:hands sweating, than anyothertimeinhertherapy. She “saw” thewholesceneandwent through itasusual. reported shehad“re-lived” thetraumamemory, butthistimeitwascompletelydifferent technique usedinFunctional Analysis.Nothing happened.At theendofsession,she session so I had no awareness of her episode of trauma. I worked with the gentle touch before thedemonstrationa traumaticexperience.Ididnotgointoherpersonalhistory and she would besexually assaulted. Luckilyif she sheescaped, struggled but it was still at 12years old.She wastiedtoadangerous machine;themachinewouldbeturnedon group, Ididademonstrationsessionwithtraineewhohadtraumaticexperience trauma with the undamagedself in which, the systemisstill functioning well. In a training background requiring noexplicitattention. body (Körper)whichisperceived by theselfandothers. The subjectbodyisamediumor distinguishes between thepre-reflective, unperceived subjectbody(Leib)andthephysical 573). Rather, they are disturbances of a person’s “being-in-the-world” state(p. 571).Fuchs security whereby “mental disorders are nottobeconsidered asmere braindysfunction” (p. facts are friendly” (ascitedinRyan, 2003,p. 75). June, 2013).In thisstate,there are onlydesires, notneeds.AsRogers suggested,“All the Bioenergetic therapistOlaf Trapp (personalcommunication, callsthe“undamaged self” exists before andisuntouchedby disturbance,trauma,lack,andconflict;itiswhatthe and well-being. The immutablequality, whileinterfered with,doesnotchange. The ES (1969) beingstate. When onereturns tothedeeperself, there isalwaysasenseofsecurity and Well-BeingSecurity WILL DAVIS Working withschizophrenics, Fuchs’ (2009)embodimentrepresents anotherfacetof Immutability isreflected inthenextcharacteristicwhichis reminiscent of Maslow’s Fuchs (2009)pointsoutthesamequalityinschizophrenia. growing “With alienation, When aiding patients to experience the ES, it ispossible to work before the onset of a linked towhathappensoutside.”(p. 572) background, athought/feelingofbeingempowered —sure ofmyselfanditwasnot a patientfacingpotentiallydangerous situationreported havinghad“…inthe situations, thusconnectingtheselfandworld…‘intercorporality’… Recently, It provides afluid,automaticandcontextsensitive pre-understanding ofeveryday belonging totheworld the world. to‘existentialThis appliesinparticular feelings’ suchas bodily feelingsare atthesametimefeelingsofbodilystatesandwaysexperiencing a pre-reflective know-how Thus thelived bodyalsocorresponds tothe bedrock of [emphasisadded].(p. 574) [emphasis added].Radcliffhas argued recently that basic unquestioned certainties…as feeling athome, which carriesitsown intrinsicvalue withit. That istosay, itisanendinitself. It isfeltto peakexperienceisfeltasaself-validating, self-justifyingmoment(1968) writes,“The Familiarity: Knowing theKnower in schizophrenia are misinterpretations ofnaturalstates. ordistortions dangerous. This isReich’s onschizophrenia; view alotofthestrangeexperiencesinherent experiencing the “implicit body” in an already splitoffstate, which is thusdisorientingand here are “growing alienation”. To sayit simply, in the caseof schizophrenia, the person is become available forconsciousintrospection” (Fuchs, 2009,p. 572).Ithinkthekeywords processes (thepre-reflectivewhich meansthatnormallytacitsensory/motor lived body) the term“reperceiving” (2006, p. 5)asafundamental “ to experience, which involves curiosity, nonstriving andacceptance” (p. 5). They suggest (2003, p. 75). “In selfdetermination,there true isnofixed concept ofselftoprotect or enhance” and isnever experienced asevilorundesirable” (1968,p. 81). forRyan:The sameistrue Willie Nelson sings,“Your dreams willbedreaming you.” mentioned earlier;sheknows thatifwe are notabletorealistically evaluate ourselves, as between different levels ormanifestationsofherself. This isnotthe“creative illusion” self there isnocomparing,judgingcognition—butthere isevaluation. She differentiates is amore senseofself, important rooted inthelived body, beyond judgment.In theendo context ofthesocialself, sheseesherselfasboth“good” and“bad”. She issuggestingthere once saidtome,“Ilove myselfbeyond thegoodandbad.”It isclearthatwithinthe Nonjudgmental butReality-Oriented Once shegotpastthedistraction,recognized herself. The usual self-concept was seen for what it was: distraction. in the absence of myself”. as awhole” (p. 34).Apatientofmineexpressed thisclearknowing as“an extreme presence Maturana (1998)writes,“Knowing istheactionofknower…rooted inthelivingbeing experience andrequires notranslationtomakeitmeaningful” (p. 421). The biologist phenomenological systemisanthropomorphic. Its dataisstatedintermsofimmediate (Pagis, 2009).Earlier, Syngg (1941)hadwrittenthesameindifferent terminology: “A (p. 267).Experiences are notsublimated;theyarise“with content”recognizes itself” Pagis, 2009)writes,“At theroot ofourexperiences,we findabeingwhichimmediately disciplines: philosophy, psychology, and biology. The philosopher Merleau-Ponty (in said: “It doesn’t matter. It ismore tomethanitisyou.” important the endofasession,onepatientcouldn’t findthewords todescribehow hefelt. Finally he a “new”, known, profound experienceandyet haslittletosayaboutit.It isself-evident.At need fordiscourse.In Functional Analysiswe call thisthe“Haiku effect”. The patienthas no needto justify orexplain. Pagis (2009)has pointed out thatin these statesthere is no away from itsdignity” (p. 79).Because itisfamiliar, there issecurityandtherefore there is be sovaluable anexperience,sogreat arevelation, thateven toattemptjustify ittakes Security andwell-being are rooted inthefactthatESstateisalwaysfamiliar. Maslow In mindfulness,Shapiro, Carlson,AstinandFreeman (2006)refer toan“orientation Maslow peakexperienceisonlygoodand desirable, echoes thissentimentwith:“The The nextcharacteristicoftheendoselfexperienceisanonjudgmental state.Apatient It isvaluable tonotethatthisqualityoffamiliarityisreflected inthree disparate shift inperspective THE ENDOSELF ”. In arecent 45 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 46 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS separation between preverbal andverbal. conscious “logical” decisions. unconscious rightbrainemotional regulation ismore significantintheadult statethan years old.Until thentherightbrainprocesses allemotional experiences.Schore arguesthat does notcome“online” untilabout18monthsanddoesnotdominatefive Mitchell, 2000,p. this: 37).Cozolino supports unhampered by lawsofcontradiction,causality, timeand subject/object” (ascitedin Preverbal andNonverbal said itthisway:“Idon’t sufferfrom mysufferings.” more thanthat” (Shapiro etal.,p. 6). There isnoproblem abouttheproblem. Apatient self anditstroubles. “If we are abletoseeit,thenwe are nolongermerely it;we mustbe own internalexperience” (Shapiro etal., p. 6). There is a contactfuldistance between the development process whereby onegainsanincreasing capacityforobjectivityaboutone’s referring toasanendopsychic stateis“…simplyacontinuationofthenaturallyoccurring which whatwaspreviously subjectbecomesobject. What theycallmindfulnessandIam cited inShapiro etal.,2006,p.5). Segal, 1990), them. Reperceiving is akin to the Western psychological concepts of meditation isthatthephenomenacontemplatedare distinct from themindcontemplating first able to stand back and simply witness it. As Golemanrealization in suggests, “The (2013, p. 69). intheIBPJ,Greenearticle callsit“self observation”, “spectating ratherthenparticipating” WILL DAVIS Shapiro et al.goontopointoutthatreperceiving isarotation inconsciousness Rather thanbeingimmersedinthedramaofourpersonalnarrative orlifestory, we are Loewald takes this theme further: there takesthistheme further: is language within the womb,Loewald where there isno This applies to any early experience. According to Schore (2006) the logical left-brain Yet, process is writes:“…theprimary canbechallenged.Loewald thisclassicalview Mitchell onlanguageanditsdevelopment: elaboratestheclassicalview immersed, embedded inaflow andparcel ofaglobal experience of speechthatispart grasp thewords, butasif speaking toherselfwiththe infant included…[H]eis The motherspeakswithor to theinfant,notwithexpectationthathewill on whichmostofourdecisionsare based.(2002,p. 158) choice. In we have truth, littleornoconsciousaccesstotheinformationlogic informationandhave madeaconsciousfeel andactasifwe have allthenecessary both outsideofconsciousawareness andprocessed priortoconsciousawareness we Despite thefactthatvast majority oftheinformationwe acquire andencode is later psychological self. (2000,p. 5) the linguistic-semioticsystemthrough whichhewillbecomeaperson,andhis opened upbetween theearlymonthsoflife,before thechildisinductedinto understand theunconsciousitselfintermsoflinguisticstructures. Adividehas stuffofthemind…[F]ollowingmentation isgenerated,thevery Lacan,many century, languagehasbecomeunderstoodasthematerialoutofwhichadult between thepreverbal andtheverbal. Increasingly over thecourseof20th development asbifurcated by afundamentalandperhapsunbridgeabledivide Most philosophers and psychologists of language regard early human deautomatization (Deikman etal.,1990)and detachment decentering (Bohart, 1983)”(as(Bohart,

(Safran &

listen torecorded storiesread tothemby theirmother cognition andcanlearn.Mitchell thenasksustoconsiderthis“…astoundingfinding. voice” (2002,p. 88).Hepner (2002)reports cognitive changes asevidencedbybaby’s thenewborn birth, instincttoorientthesoundofhermother’s (Mitchell, 2000,p. 8).For Cozolino, are “Systems active even ofimplicitmemory before to “distinguish intonation,frequency, variation, andphoneticcomponentsofspeech” by thesameauthorread Beebe etal.notethatthesebabiesare tothemafterbirth. able patient’s historicalpast.In addition,theydealwith the pastandpresent in termsof of TimeOutside comprehended” (Voeikov, 1999,p. 20). natural process. Yet, themainlawoflife,steady increase oforganization,isnot yet the higher from uniform and incoherent to differentiated but indivisible, is the main pointofview.is impossiblefrom aphysicsandchemistry The process ofthelower to conflicts. As well, according tothebiologist Vernadsky, “…theprocess of development OPD claims:continuallyrestructure itselftohealorovercome deficitsor unresolved psychology/psychotherapy cannotanswer thequestionofhow asystemcandowhatthe in thelivingprocess itself. Without aninnate,restorative resource, deficiency-oriented the aforementioned undamaged,secure, known state oftheendoself, whichisfounded adapt tochangingcircumstances, tocreate order outoffluctuations/disorder, is rooted in and externalenvironment) innon-equilibrium structures” (1997,p. 5). This abilityto circumstances. Prigogine refers to“order through fluctuations(changesintheinternal same phenomena: the ability of an organism to continually reorganize itself in changing jargon: optimal,temporalstructuralization. The OPDandJantsch are describingthe (p.41). The physicistJantsch (1979)saysitmore pieceof succinctlyinawonderful flexible andhascreative functionsthat regulate andadaptwithinbetween individuals” restore theirintrapsychic andinterpersonalequilibria.Ahighlyintegrative structure is “Structure liesatthebasisoflongtermpersonalstyleinthatindividualstimeand again Spontaneous, continuous re-organization medium consciousness isasymbolizing process thattakesplacethrough a do notrequire conceptualizationorverbalization “Somatic tobemeaningful: self- (1987) called it the “unthought known”. Pagis types of experiences sees that certain there are nowords but experiences are nonetheless registered and remembered. Bollas pre-verbal, and the non-verbal level through embodied cognition, the lived body, where second isthat“someone” isregistering theseexperiences. This research ofnonverbal experiences,andthe twopoints:oneistheimportance supports Words are salientfeature ofbabies’ but experience,notafterbirth, Astudyby deCasperand Fifer (inMitchell, 2000)proved this.Babies preferred to Time themeinpsychotherapy. isanimportant Psychotherapists typicallyfocusonthe The OPD’s (2001) description of a healthy psychic structure is a fundament of the ES. An advantage ofworking functionallyisthatitpossibletowork ontheverbal, the a uniformexperience.(ascitedinMitchell, 2000,p. 8) perceive words, but is bathed in sound, rhythm, etc., as accentuating ingredients of within themother-childfield. Whilethemotherutterswords, theinfantdoesnot ” (2009,p. 268). in utero than to recorded stories in utero in utero nonverbal, embodied THE ENDOSELF ; thefetushas ” (2000,p. 8). 47 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 48 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS the behaviorsof thesestructures throughout allrelationships in laterlife. This beingstate It is alsothesource ofalllatterdifferentiated psychic structures andcontinues tounderlie development. The endoselfisthesource ofalldrives anddesires bothoutward andinward. autopoietically, thisselfiswhatbrought toinitialrelationships, leadinginturntoitsown a coherent, sometimescognitive senseofself-existing before relation toothers.Arising andtherapy.developmental theory Ihave arguedforanearlystateofsubjectivitythatis does notexist” (2011,p. 41). conclusion, formanytheoretical physicistshave cometobelieve thattime fundamentally The rift between the time of physicsandthe time of experienceis reaching itslogical relativity suggest that there is “…no special present, and that all moments are equal. ‘out oftime’” (2012). neuralsubstratesofemotions…are thereforetaken intheCambridgeDeclaration: “The experiences(Schore, forpositive, life-supporting also true 1999),reflecting theposition flashbacks are alwaysinthepresent andtotalsystemexperiences(pp. 272-273),whichis in time.Cozolino (2002)concludesresulting intheabsenceoflocalizationmemory regions ofthereptilian andleftbraininvolvement, andlimbicbrainwithlittlecortical periods. patients stop breathing, with no sense of holding their breaths, for frighteningly long at theendofsessionhow theylostthesenseoftime.Furthermore, Ihave witnessed experience themselves asslowly drifting,floating,orinahypnagogicstateandcomment (1968, p. 80).In osteopathy, itiscalledthe“still point”. In Functional Analysis,patients some placeinanotherworldwhichtimesimultaneouslystoodstillandpassedrapidly” 2000). for Maslow’sThe same is true being state, about which he says, “It is as if they had relevant. prognosis ofthetherapy. Despite this,auniquequalityoftheendoselfisthattimenot sense ofhisfuture isagooddiagnosticindicatorofhis present stateandtheprogress and transference, projective identification,projection, and regression. As well, thepatient’s WILL DAVIS Brain research isnow showing usthattraumaticevents are stored inthemore primitive process as“unhampered describestheprimary Loewald by…time” (ascitedinMitchell, The physicist Callender supports ReichThe physicistCallendersupports whenhewritesthat Einstein’s theoriesof In the1940’s, Reich (1967)wrote: My is that, while essential, the role view of the other is overemphasized both in functions oftheorganism has maintainedthatsplithisentire life. his organismwhichhesuffered whenhewasinthedeadenedmother’s womb; he actuallydoesistobecomeavictimof historical events. The schizophrenic does not ‘go back to the mother’s womb’; what psychological term describing the actual, present day effectiveness of certain The schizophrenic doesnot‘regress tochildhood’. Regression ismerely a experiences. attitudes. The make-upofthepersonisfunctionalsumtotalallhispast whole experientialworld ofthepastwasalive inthepresenting ofthecharacter form There isnoantithesisbetween thehistoricalandcontemporaneous. (p. 121) ANDNOT WITH HISTORICAL EVENTS. (p. 492) Summary We are dealinghere withactual,present day exactly thesamesplitincoordination of and he The of the of theplasmaticbasisearlydisturbances.He isontheInternational Boards Advisory considered oneofthemajorresearchers inthefieldsoffunctioninginstroke and in Europe. Will developed the body-oriented psychotherapy, Functional Analysis, and is various alternative healingmethods.He conducts bodypsychotherapy trainingworkshops psychology degree andwastrainedinEncounter Groups, Gestalt Therapy, Radixandin Will Davis (1943)isanAmericanwith40years experienceinpsychotherapy. He hasa BIOGRAPHY (Robinson, 2011,p. 16). of thisapproach seeks:“...toseehow theminddescribesitself” self-organizing,andself-regulating.is self-starting, The resource, competencyorientation Fuchs, T. (2009).Embodiment and psychopathology: Aphenomenological perspective. Fonagy, (2002)P. Primary aggression, thedisobjectalizing functionandviolenceinthe Eagle, M.(1991).Psychoanalytic conceptionsoftheself. In J.Strauss & G.Goethals (Eds.), Eagle, M.(1987).Developmental deficits versus dynamicconflict. Damasio, A.,(2000). Davis, W. (2013).In Support ofBodyPsychotherapy. Davis, W. (2006).Instroke, empathyandthetherapeuticrelationship. Paper presented atthe psychotherapie Davis, W. (2000). Theoretical Contributions.In G.Strum &A.Printz (Eds.), Davis, W. (1999c).Elements ofbuildingarelationship: embodyingrelationship. Paper Davis, W. (1999b).Instroke undneuordnung. In Lassek,H.(Ed.), Davis, W. (1999a).AnIntroduction totheinstroke. Davis, W. (1984). Working withtheinstroke. Company. 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Stern, D.(1998). Schubert, T. &Koole, S.L.(2009). The embodiedself: makingafistenhancesmen’s power- Schore, A.(2006).Paper Presented attheIVInternational Biosynthesis Congress. Lisbon. Schore, A.(1999).Clinicalimplicationsofapsychoneurobiological modelofprojective Voeikov, V. (1999). biologicalparadigm. The scientificbasisofthenew Uvvnâs-Möberg, K.,(2004).Paper presented attheEuropean AssociationofBodyPsycho- Totton, N.Embodied relating: The ground ofpsychotherapy. In publication. Tonella, G.,(1999)Paper presented atthe2ndEuropean Bioenergetic Congress, Taylor, S.,Kemeny, M.,Reed, G.M.,&Aspenwall,L.(1989).In J.Strauss &G.Geothals. Review. Syngg, D.(1941). The needforaphenomenologicalsystemofpsychology. related selfconceptions. identification. In S.Alhanati(Ed), Primitive mentalstates.hIII. Binghamton, NY: ESF. DOI:10.1002/jclp.202372 of 21st Century Science& of 21stCentury Technology. therapy Congress. Athens. Barcelona. (Eds.), Assaultontheself:positive illusionsandadjustmenttothreatening events. In self: interdisciplinary approaches 48,(pp. 404-424). The interpersonalworld oftheinfant. Journal ofExperimental SocialPsychology. Journal ofClinicalPsychology. (pp. 239-255).Berlin: Springer-Verlag 12(2),pp. 18-33. London:Karnac. 45,pp. 828-834. International Journal Psychological THE ENDOSELF The 51 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 52 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS basics, thatis, from thedefinitionofsystems, sincealllivingorganisms canbeconsidered isillustrated,followedhistory by concludingremarks. conflict theory, somatic basedtherapies,object relations, andselfpsychology. Lastly, acase 2001). Anintegrative modelisthenproposed whichbringstogether egopsychology, drive- followed basedonthework of Porges introduction by topolyvagal ashort theory (2001& dynamical systems.Formal definitionsforemotions,feelings,and affectsare then. Thisis environment. This paperisorganized asfollows: First, adefinitionispresented forcomplex trauma maychangetheindividual’s metabolismofenergy, and exchange ofenergy withthe It mayalsochangetheshapeandfunctioningofinternalorgans.Chronic developmental at othertimes,resulting inalossofmotilityandlimitingtheindividual’s lifeandaliveness. oftheindividual,makingitrigid attimesorflaccid trauma maychangethebody(boundary) flow of information, and flexibility of response to the surrounding. Chronic developmental Chronic developmental traumachangesthewayanindividualinteractswithenvironment, or sheis,beingseenasanobjectforthesatisfactionof parents’ narcissistic needs,etc. perceived existential threats orsuffersfrom contactdeprivation, notbeingseenforwhohe of achildduringhisvarious developmental stages.Asneedsare thechildfaces frustrated, © Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 13,Number 1,spring2014 International BodyPsychotherapy Journal HOMAYOUN SHAHRI,PH.D., M.A. somatic psychology. drive theory, emotions,neuroscience, objectrelations, polyvagal theory, selfpsychology, for bodypsychotherapy. psychology oftheselfwithinproposed integrative modelisdiscussedwithimplications from neuroscience isalsoprovided. nature ofconflictpsychologyThe complementary and material in theformationofdevelopmental traumaisalsodiscussed,forwhichsupporting of complex dynamical systems and energy exchange are presented. of shame The importance integrative model.Formal definitionsofemotions,feelings,andaffectsbasedonthetheory self psychology. The latestneuroscientific findings are the proposed presented tosupport integrate egopsychology, drive-conflict theory, somaticpsychology, object relations, and In thispaper, anintegrative modelfordevelopmental traumaispresented thatattemptsto In order from tounderstandtheeffects ofdevelopmental the trauma,itis helpfultostart The developmental modeldiscussedinthispaperisthechronic traumaticexperience Keywords: Toward anIntegrative Model for Developmental Trauma characterstructure, complexdynamical systems, developmental trauma, Received 12November 2013;acceptedJanuary 2014 Homayoun Shahri,Ph.D., M.A. ISSN 2169-4745Printing, ISSN2168-1279Online The Art andScienceofSomaticPraxis Introduction Abstract Figure 1.Systems canbeopenorclosed. characterized by theirinternallawsoffunctioning.Ageneralsystemmodelisshown in the systemoperatesandexchanges energyormatterwithitssurrounding. Systems are also 2013). maybereal ornotionalbutitdefinesafinite volume,withinwhichThis boundary characterized by theirboundaries,whichseparatethemfrom theirsurroundings (Gros, Systems transforminputsthatare consumedintooutputsthatare produced. Systems are group ofinteracting,interrelated, andinterdependent elementsandboundedprocesses. as dynamicalsystemsinthemostgeneralsenseofterm.Asystemcanbeviewed asa systems tendto move toward homeostasis,thatis,self-regulation and stability. by repairing damage; anddefendingagainstexternaltreats (Damasio, 2003).Livingcomplex balance oftheinteriorcompatible withtheprocesses oflife;maintainingtheorganism’s structure energy; incorporating,consuming, andtransforming energy and matter; maintaining a chemical evolved to handlethebasicchallengesoflife. These challengesinclude:finding sources of Emotions, Feelings, andAffects and affects(allofwhichcontainenergyinformation). exchange withenvironment, interactwiththeirsurroundings viatheiremotion,feelings, a singlecellorascomplexhumans.Livingsystems,aside from basicenergyandmatter of information(entropy) andmaterial-energyexchanges. Livingsystemscanbeassimple environments (they’re open). This interactionwiththeenvironment takesplaceby means complex andself-organizing,have thespecialcharacteristic oflife,andinteractwiththeir interaction ofelementsthatmakeupthesystemandresult inself-organization(Gros, 2013). an externalentityorelementthat’s affectingit. This structure orpatternformsfrom the is theprocess by whichthesystemmayformastructure orpatterninitsbehaviorwithout Complex systemsare openanddynamical,tendtobeself-organizing.Self-organization relationshipssystem interacts and forms new with its environment and surroundings. a system indicates how relationships give behaviors and howbetween rise to new parts a is saidtobedependentonthetimeandpositionofsysteminspace.Complexity

All living organisms, from single cell amoebae to humans, are born with innate abilities Living systemsare considered subsetsofallsystems. Livingsystemsare by definition The dynamicalsystemconceptisaformalizationinwhichthebehaviorof Figure 1.Basic System Model TOWARD ANINTEGRATIVE MODEL 53 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 54 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS According toPorges: 123). The second branch is controlled by the ventral and is unique to mammals. vagal nerve and isbehaviorallyassociatedwithimmobilizationfreeze behavior” (Porges, 2001,p. vagus thatcontrols digestion,andresponds tothreats by depressing metabolicactivities controlled “…characterized by by thedorsal vagus aprimitive nerve, unmyelinated visceral system. systemandthesympatheticnervous parasympathetic nervous (afferent) nerves. system,ontheotherhand,isdividedinto The autonomicnervous divided intomotor(efferents) systemisfurther andsensory The somaticnervous system. systemandtheautonomicnervous nervous dividedintosomatic-sensory further system (spinalcord).system andthecentralnervous systemisThe peripheralnervous Polyvagal Theory for actionisdescribedby Porges (2001 &2011). inpolyvagal theory or inotherwords, theexpression orenactmentofdrives andinstincts. This mobilization energetic states(emotions)ofthebody, aslifeisexperiencedmoment-to-moment. think offeelingsasmentalsensorstheorganism’s interior;thatis,mentalsensorsofthe role inemotionsandfeelings(Damasio,and hasanimportant 1994). In summary, we can intheenactmentofdrives andinstinctsshould benotedthatthelimbicsystemparticipates interacting withtheenvironment. However, innatedrives are theprocess. It neededtostart withof emotions,offersaflexibility response basedonpastexperiencesofandhistory feelings. It tonotethatfeelingemotionalstates,isbeingconscious isalsoimportant of internalemotionalstates(bodystates).Consciousawareness ofaffectsalsoresults in the emotionofjoy. This emotionmaythenbe perceived asthefeelingstateofhappiness. scenery, whichmaychangeourbodystate,perhapstoastateofrelaxation, resulting in themes”and of thoughts with certain (p. 86). As an example consider the sight of beautiful modeofthinking bodystateofthealongwithperception ofacertain of acertain 1999). Damasio (2003)provides thefollowing definition:“[…]afeelingistheperception processing prepares thebrainandrest ofthebodyforaction” (1999, p. 125). appraising processes ofthebrain” (Siegel, 1999,p. 123).Siegel alsostates,“Emotional “Emotions represent dynamicprocesses created withinthesociallyinfluenced, value and gaze, tone of voice, body posture and motion, and timing of response (Siegal, 1999). are primarilycommunicatedby nonverbal behavior, suchasfacialexpression, eye contact occur intheface,voice, inspecificbehaviors” (Damasio, 2003, p. 28). Emotions body. “Emotions are actions ormovements, manyofthempublic,visibletoothersasthey (Damasio, 2003).Emotions intheirsimplestformcorrespond totheenergeticstatesof HOMAYOUN SHAHRI,PH.D., M.A. Siegel (1999)defines “affective expression” orsimply “affect” astheexternal revelation Feelings intheirmostbasicformare perception ofemotionsorbodystates(Siegel, At thetopofprocesses thatpromote homeostasisare emotionsandfeelings The parasympathetic nervous systemhastwomaincomponents: The parasympatheticnervous The firstbranchis systemisdividedintotwobranches: theperipheralnervous The humannervous I willnow discusstheprocess by whichourorganismmobilizes foraction(energetically), in metabolicoutput tomatchenvironmental challenges.(2011, p. 160) and are tone toprovide capable ofrapidshiftsincardioinhibutory dynamicchanges In express mammals,visceromotor fibersof the heart highlevels of toniccontrol […] bronchi, esophagus,andheart. pharynx, visceral organsincludingthe larynx, The ventral vagal control complex(VVC) ofsupradiaphragmatic hasprimary which isresponsible forfacialmuscles(emotional),eyelid opening(looking),middleear The myelinated ventral vagus complexcharacterizes thehumansocialengagementsystem, community. The ventral vagus complex(VVC) needs. istheresponse totheseevolutionary foe, determineandevaluate thesafetyofenvironment, andcommunicatewiththe responses. Mammals ontheotherhand,inorder hadtodistinguishfriendfrom tosurvive, systemtomodulatecardiacthe sympatheticnervous output andmobilization,freeze fight andflight (Porges, 2001). for thus increasinginhibiting the dorsal vagus mobilization behaviors nerve, necessary (SNS). systemiscapableofincreasing metabolicoutputandThe sympatheticnervous and dependon, amongotherthings,theemotional state(energeticstate)of themind-body. hypo/hyper-arousal. Also ofnoteisthattheboundaries between thesezones rigid are notvery optimal zone ofarousal (activation ofthesocialengagement system)yet experienceelementsof as beinghighlyaroused (ready foraction)butunabletomove. It isalsopossibletobein the one can simultaneously be both hyper-aroused and hypo-aroused, which would be experienced tomentionthatthestates depicted inFigureimportant 2are notmutuallyexclusive, inthat arousal states by normal fluctuations in arousal (Ogden, Minton, & Pain, 2006). It is also very traumatized peoplehave anarrow window oftoleranceandcaneasily shiftintohypo/hyper- 2), experiencefluctuationsinemotionsandfeelingsasunmanageable anddysregulating. Most On theotherhand,peoplewithanarrow window oftolerance(themiddleregion inFigure and sensations—anumbing,senseofdeadnessoremptiness, passivity, andpossiblyparalysis. other hand,somethingdifferent isexperienced,namely, adownward modulationofemotions images, feelings,affects,andbodysensations. When anindividualishypo-aroused, onthe to process informationeffectively and isusuallyoverwhelmed anddisturbedby intrusive is activated. When anindividualishyper-aroused, thepersonexperiencestoomucharousal the window oftolerance within whichthesocialengagement system(ventral vagal complex) Finally, thedorsalvagal complex(DVC) istheimmobilizationsystem(Porges, 2011). (SNS), whichisanadaptive mobilizationsystemengagedduringfightorflightbehaviors. communication. systemThe second complex in the hierarchy is the sympathetic nervous ventral vagal complex(VVC), amammaliansignalingsystemformotion,emotion, and system engages. The followingAt thetopofhierarchy isthe canthusbeobserved: When asystemhigherinhierarchy fails,thenamore primitive branchoftheautonomic (Porges, system. 2011)proposes ahierarchical organizationoftheautonomicnervous rate,resultingrapid changesinheart inmobilizing orcalmingeffects.Polyvagal Theory The ventral vagal complex,therefore, actsasabreak oncardiac outputandiscapableof without requiring actualactivation ofthesympatheticoradrenal system(Porges, 2011). vagal mobilization and expression system can result of the sympathetic tone in temporary engagement oftheformermore primitive systems. Thus, activation ofthemyelinated evolution oftheventral vagal complex,thecardiac outputismodulatedwithoutthe cardiac outputrespectively, andthusmodulate mobilization.In mammals,withthe systemhave theopposingfunctionsofdecreasingsympathetic nervous andincreasing muscles ofvocalization andlanguage,musclesforhead-turning(Porges, 2001). muscles (differentiating ahumanvoice from background noise),musclesofingestion, The more primitive life forms use theunmyelinated dorsal vagal complex (DVC) and system systemisthesympatheticnervous The otherbranchoftheautonomicnervous Figure 2,adaptedfrom Ogden andMinton (2000),shows thethree zones ofarousal and In more primitive lifeforms(pre-mammals), thedorsalvagal complexandthe TOWARD ANINTEGRATIVE MODEL 55 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 56 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS and other authoritarian forces. It can be seen that the content of the prohibition of the the outside world (segment 2). This counter-force may include parents, school, society, force fromexternal objects(segment1), whichthencomesintoconflictwithafrustrating been discussedby Hilton (2008)ingreat detail. taken andadoptedfrom Reich (1980). This model,inaslightly modifiedform,hasalso and canalsopointtotherapeuticstrategies. With thatinmindisthefollowing diagram, developmental traumatakesshape. (orconflicttheory,This modelisbasedondrive theory psychic analyzed by qualitythatcannotbefurther introspection (Kohut, 1978). to beexpressed toavoid thestateofnegative tension.Drives canalsobeconsidered asthe energy ofthedrive isreduced. is satisfiedhowever, theorganism returns toastateofhomeostasisand relaxation, andthe physiological needsthatwhennotsatisfiedleadtoanegative stateoftension. Whenaneed actions. The term“drive” refers toandisbasedontheprinciplethatorganismshave certain An Integrative Model forDevelopmental Trauma HOMAYOUN SHAHRI,PH.D., M.A. This diagram(Figure 3)depictsadrive whichseeksexpression by moving toward A model,basedonthework of Wilhelm Reich, seemstoclarifythemeansby which According tothetheory, theenergyofdrive tendstoincrease over timeandneeds by brieflydescribingdrives,I willstart whichare thebiologicalcore ofmotivations and http://www.sensorimotorpsychotherapy.org/articles.html Psychotherapy Institute,” by P. Ogden, &K.Minton, 2000,Retrieved from Figure 2Optimal Window ofArousal. Figure 3.Drive, repression, andidentification Adapted from “Sensorymotor frustration), therefrustration), istheformationofarmorinformmuscularblocks,and answer seemstobethearmor(segment6). Where thetwomeet(drive andenvironmental (segment 2):how istherepression maintainedby thedrive thatturnsagainstitself? The itself (segments3and5,4)(Reich, 1980). toward theworldandseeksexpression inanalternative way, andonethatturnsagainst to turnagainstanother(segments3and4). The drive splitsintwodirections, onethatgoes direction ofthedrivedissociation orcleavage (expression) ofaunitary thatcausesonedrive of thepressure exerted from theouterworld,anantithesisdevelops withintheperson,a maintained comesfrom oftheindividualhimself. theenergyreservoir Under theinfluence drive comes from theoutsideworld,but cathexis (energy) with which prohibition is understood, and healsoneedstofeelthat isunderstood. This iswhatHilton (2008 & contactlessness, toachieve fullhealing. Reich mentionedthat thepatientneedstobe maintains thearmor. One mustsimultaneouslywork onthisresidue which,Reich’s psychic 6) andsomerelease of the impulseisnotenough,asaresidue willremain thatstill can onlybedissolved withinahealingtherapeuticrelationship” (2008,p. 94). experience thatthispsychic contactlessness,the result oftheclient’s narcissistic position, and itthusneedstoberesolved inatherapeuticrelationship. Hilton says,“It hasbeenmy patient needstobeunderstood,andhefeelunderstood” (1980,p. 319). said,“Inexperiences, andhefurther order tohealthepatient’s psychic contactlessness,the experienced by theindividualatthispoint,orastateof“no contact” andisolation. where nothingmoves anymore. Subjectively, Reich (1980)statedthatan“innerdeadness” is contactlessness’, whichhedefinedasthepointintherapyseemsto reach apoint how isitexperienced? The pointatwhichthesplittakesplaceReich (1980)named‘psychic be (segment6). could thenpostulatethatthestronger thedefense(segment4),thickerarmorwill tensions inaccordance ofthedrive thathasturnedagainstitself. withtheportion One deeply repressed impulsesanddrives. Thus thearmordevelops asmuscularblocks and a simplification,asin reality thearmorislayered, andawarded-off drive wards offmore block comesfrom thedrive itself, whichnow hasturnedagainstitsoriginalgoal. This is physical tensionsthatkeepthedrive from expressing itself. The energythatmaintainsthis A questionarises,namely, intheabsenceofrepressive force from theoutsideworld Thus itcanbeconcludedthat simplyreducing thestrength ofthearmor(segment This psychic contactlessnessoccurred inarelationship withacaretaker earlyinlife, Reich believed thattheoriginofthispsychic contactlessnessstemmedfrom childhood A different question that arises is: how does thesplitting of the redirected drive happen and concealing itfrom himselfandfrom the analyst.(1980,p. 310-311) ofhisnarcissisticthe lastreserves positionandthathewasextremely clever in seemingly beyond reach. One hadthefeelingthatpatientrefused with topart of vegetative energywere achieved, anun-definable residue always remained, behavior hadbeencompletelybroken down, even afterfar-reaching breakthroughs factor.most important We graduallycametoseethateven aftertheformalmodesof embrace thepsychic armorinitstotality;indeedthatitprobably overlooked the of theformalmodesbehavior. Lateritwasshown thatthisconceptdidnot repressing defenseforces; itcouldbedynamicallybroken down through theanalysis Originally, characteranalysisconceived ofpsychic armorasthesumtotalofall In hisbookCharacterAnalysis, Wilhelm Reich writes: TOWARD ANINTEGRATIVE MODEL 57 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 58 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS shame: be clearregarding theprocess andperception ofshame.Schore elaboratesonthestateof PNS, asthecauseofexperienceshame.However, thereader shouldunderstand and system (PNS)following theactivation of VVC (thesocialengagementsystem)branchof points to activation of theDVC (the freeze system) branch of the parasympathetic nervous sympathetic system(Schore, 1994).Recent research inPolyvagal (Porges,Theory 2011) associated withelevated parasympatheticsystemactivation following the activation of affective resonanceimpede further andcommunication” (p. 206).Shame ingeneralis contact andrelationship. Iwillreturn tothistoward theendofthisarticle. and malignantlong-lastingeffectsofshamethrough re-establishment oftheempathic of parenting (Siegel, 1999).In myopinion,parents andsocietymustundothedamaging socialization ofchildren, parents donotneedtouseshameintentionallyasastrategicform freeze system(DVC) isexperiencedasshame.Siegel pointsout: The perception ofthisshiftfrom activation ofthesocialengagement system(VVC) to the action thatisintheprocess oftakingplace. This process isshown pictoriallyinFigure 3. expression ofthedrive by mobilizingthedorsalvagal complex(DVC) to immobilize the by theenvironmentthen befrustrated (caretaker, etc). The organismwillthenblockthe state (emotion)anditsperception whichmaybeagoodfeeling(feelings). This drive may output, thusincreasing theindividual’s energytoactandresulting inadifferent energetic by theventral vagal complex(VVC, orsocialengagementsystem)whichincreases cardiac can healpsychic contactlessness? what is the neuroscientific that the healing therapeutic basis for the assertion relationship personal communications,February 2009)callsthe“healingtherapeuticrelationship”. And HOMAYOUN SHAHRI,PH.D., M.A. A drive (impulse)isformedintheorganismresulting inincreasing arousal mediated Schore (1994)writes,“Shame anditfunctionsto isexperiencedasaninterruption, forAlthough experience of shame is evidently inevitable and perhaps necessary universe” (1994, p208). called “primary narcissism” towhatSartre describedasashametriggered “crack inmy of thisaffectisthusasudden, unexpected,andrapidtransitionfrom whatFreud hole inthemiddleofone’s being. The individual’s subjective consciousexperience — avisualrepresentation ofaspiralandasflowing offorleakagethrough adrain grandiose omnipotencehasbeen phenomenologicallycharacterized asawhirlpool if hecoulddie. The suddenshock-induceddeflationofpositive affectwhichsupports there, intoground, whichimpelshimtocrawlintoaholeandculminatesinfeelingas to disappear from view, one’s and an impulse to bury face or to sink, right then and individual whothenexperiences—asenseofdispleasure plusthecompellingdesire under aburninglightinpublicview. Shame throws a“floodinglight” uponthe self are exposed.It isasthoughsomethingwe were issuddenly hidingfrom everyone this negative affect,visibledefects, narcissistically charged undesirable aspects of the of withdrawal.Under thelensof“shame microscope” whichamplifiesandexpands the face—toescapefrom thisbeingseenorfrom theonewhosees—andastate This misattunedrelational transactiontriggersgaze aversion, aresponse ofhiding then thebrake(theparasympatheticbranch)isapplied(1999,p. 279). go!). It’s asiftheacceleratorpedal(thesympatheticbranch) ispressed down and external NO!)inthefaceofhighlychargedsympatheticsystem(aninternalLet’s Shame isthoughttobebasedontheactivation ofparasympatheticsystem(toan the same category ofevents becomeactive (Damasio, 2003). the samecategory (ECS) thatcreated shameinthepast,prefrontal circuits thatholdrecords to pertinent and temporalparietalregions are activated duetoanemotionallycompetentstimulus saved intheorbitofrontal cortices cortex. When laterinlifethecircuits ofposteriorsensory 3), thusidentifyingwiththeenvironmental frustration. This mentalimageiseventually it thatresulted toavoid itsrepetition intheshamestate,aneffort (segment4inFigure simultaneously creating of amentalimage(bodymap)of thedrive andensuingfrustration creates apositive self-imagetoreactivate itsenergyorarousal (segment5inFigure 3)while (2006). Thus, following theshamestate,comingoutofDVC activation, theindividual energy, then becomes clear. It is shame, whichhas also been discussed indetailby Haelfaer the objectrelations), andsplitsintwo theobjecttoward whichbothlove andhateare that instincts are primarily object-seeking. The infant internalizes the object (as well as in 1952.In contrasttoFreud, whosawinstinctsaspleasure-seeking, Fairbairn believed throughout life. The term“object relations theory” wasformallyintroduced by Fairbairn but frequently continue tohave astrong influenceonone’s interactionswithothers caregivers. the primary These earlypatternscanbechanged andaltered withexperience, Object relationships are formedduringdevelopmental phases through interactionswith refers tobothreal externalothersintheworld,as well asinternalized imagesofothers. development andgrowth inrelation toreal others (external objects). The term“objects” withinpsychoanalytic theory.theory describesthedynamic process ofThe theory include thecentralarea ofthevisualfield” (p. 214). known tocontainneurons withtheuniquefeature ofhavingreceptive fieldsthatspecifically induced, shame-mediatedneurohormonal signals are registered intheorbitofrontal cortex, deactivation ofthe VVC (socialengagementsystem).Shore (1994) writes:“…visually- featureemotions. Anotherimportant ofshameisavoidance ofmutualfacialgaze dueto strong boundaries,ordoesnotpossessastrong enoughcontainmentforimpulsesand devastation, andeven murder —thatis,iftheindividualisnotgrounded, doesnothave disconnected, ungrounded anger) could break through the armor and result in destruction, brake simultaneously. The dangeristhatiftheegostrength isnotsufficient,rage(aimless, analogy todrivingacar. It isasifonefootonthegaspedal,andother system.Oneto, sinceitinvolves candrawan bothbranchesoftheautonomicnervous and humiliation.Humiliation tostudyandpaycloseattention important isparticularly system is always involveddorsal vagal branch of the parasympathetic nervous in shame arousal (VVC, i.e.,socialengagement)tohypo-arousal (DVC, i.e.,freeze). Thus, the Kohut (1978)refers tothisasnarcissistic rage.Schore writes: rejection, involvesenvironmental humiliationresults. frustration contemptandangry system isaccompaniedby aheightenedsympatheticsystem(Schore, 1994). When the humiliation. The latteroccurswhenanelevated parasympathetic(DVC inthiscase) The source of thefeelingcontactlessness, the innerdeadness, illusive psychic A further insight can be gained fromA further the school of object relations, a psychodynamic Shame, however, asdiscussedabove, systemshiftsfrom results whenthenervous It atthispointtodistinguishbetween thestatesofshameand isnoteworthy child by harsh,continuous,ormassive exposure (1994,p. 207). modulating rage typically present a background with a parent who humiliates the accompany child abuse. Narcissistic personality disorders who have difficulty isnow strong…[T]here clinicalevidencethatshame-humiliationdynamicsalways TOWARD ANINTEGRATIVE MODEL 59 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 60 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS selfobjects). This iswhatSegment 5 inFigure 3represents. This is the aspectofdrive finally those who are essentiallylikethe young human(mirroring, idealizing,ortwinship mirror theyoung human, those whoare thesource ofidealized power andstrength, or that are ofphysicalreality notpart butofpsychological reality (Kohut, 1984)),whichcan human seeksmergerwitharchaic selfobjects(innerperception and experienceofobjects (Kohut, 1971;Kohut, 1977; Kohut, 1974;Kohut, 1984)provides theanswer. The young self image)whenempathicresponses from theenvironment are absent?Self psychology not cohesive, thenhow doestheyoung humanriseupfrom theshame(andcreate apositive or shereadily identifieswiththesource ofenvironmental negativity. If theselfis,however, the freeze system(DVC). If ayoung humanhasarelatively cohesive andintactself, thenhe response —thatis,experienceashiftfrom socialengagementsystem(VVC) activation to negativity in more detail. The immediate response of theyoung human is to go into a shame force, introjectsfrustrating it,andactsitoutasshown inSegment 7. (Segmentfrustration 2, shown with dashed line), the individual identifies with the and thelibidinalegoisSegment 5inthesameFigure (Guntrip, 1971). description itcanbereadily deducedthattheanti-libidinal egoisSegment 4inFigure 3, andseeksexciting objectsintheworld.From this with theexciting object(libidinalself) andkeepstheoriginalobject-seekingdrive incheck. The egoalsoidentifies libidinal self) repressive object and the exciting object. The ego identifies with the repressive object (anti- go on in life. repressing)The bad (frustrating, split into two, namely the object is further directed. The goodobject(idealized) representations to are andare important necessary HOMAYOUN SHAHRI,PH.D., M.A. Let usconsiderwhathappenswhentheexpression ofadrive facesenvironmental This process isshown inFigure 4below. Note thatintheabsenceofenvironmental p. 111) orrejectingthe frustrating object;andthen herepresses boththeseobjects.(1952, the internalbadobjectintotwoobjects—(a)neededorexitingand(b) situation —thistimeaninternalone.How doesheseektodealwithit?…He splits also continuestowhetit.He thusfindshimselfconfronted withanotherintolerable hisneed,buteconomy ofhismindanobjectwhichnotonlycontinuestofrustrate to control theunsatisfyingobject,he[theinfant]hasintroduced intotheinner precisely inthefactthatitcombinesallurement In withfrustration… hisattempt and ontheotherhand,ittempts and allures. Indeed itsessential‘badness’ consists unsatisfying objecthas,sotospeak,twofacets.On theonehand,itfrustrates; considerationarises.UnlikeAt thispointanimportant thesatisfyingobject, Fairbairn states: Figure 4.Acting out-oldobjectrelations, andintrojects sought toeithermirror theindividual(resulting ingrandiosity),orasidealizingsources repression ofdrives result inseekingarchaic selfobjectsinlife. These archaic selfobjectsare by thechildhoodselfobjects. When thechild’s and selfisnotcohesive, thenfrustration Kohut (1971)arguesthatnarcissistic disturbancesoftheselfare duetofailure ofempathy ofthehealthyself(Kohut,not experiencedinisolation,butasanintegratedpart 1984). 1984). Self psychology positsthatinthepresence further ofahealthyself, drives are of self are dueto disturbances within self-selfobject relationships in childhood (Kohut, by selfpsychology tobethecauseofnearlyallformspsychopathology inthatallflaws self. The result oftheself, ofcourseisdefects,disturbances,ordistortions whichisposited the libidinal ego according to Fairbairn (1957), or the false self, or finally the narcissistic that seeksexpression inanalternative way, according toReich (1980),whichisthesameas shifted somewhat toadisconnectionfromshifted somewhat thebodyanditssensations. No longeristheclient, (Marcher &Fitch, 2010),tobeasstrong. One mayexpect thatthecharacterarmor might have that onewouldnotexpectcharacter armor, intheformofmuscular contractions or flaccidity body? This isaquestion thatIdonotclaimtobeablefullyanswer. Icanhowever, theorize disorders of the self has taken place in recent times, what are the corresponding changes in the changes inthepresenting issuesofpatientsandclients.If, indeed,thisshiftfrom conflictsto inthe adultworld.Itparticipants developmental toview traumainlightofthese is important them getridoftheirinfantilegrandiosity andhelpthemtobecomemore self-confident,active with anenvironment thatisempathicandunderstanding oftheirneedswhichwouldhelp that his patients are suffering from the deprivation of a give and take (optimal frustration) he isnotseeingpatientswhosecomplaintsare aboutunresolvable innerconflicts. He argues he isseeingindividuals affected by defectsoftheself. Kohut (1978,p.681) alsoindicates that unfulfillment, andlackoffeelings. associated withinneremptiness,frustrations, In otherwords, patients heisseeingdonotmanifesttheneurosis of earliertimes.Instead, heisseeingproblems between thenarcissistic lineofdevelopment and the drive-conflict basedlineofdevelopment. in anindividualsimultaneously, albeit indifferent degrees. This pointstoacomplementarity nature oftheguiltymanandtragicindicatesthatbothareThe complementary present so astobereaffirmed. Thischild,thus,becomesthetragicman,whoisinsearch oftheself. internalized parental introjects, butinthechildseekingarchaic selfobjectswithwhomtomerge negativity results notsomuchintheformationofastrong punishingsuperego intheformof self, however, isnotcohesive (duetosevere failure ofempathicselfobjects),theenvironmental becomes the guilty man who lives within the conflicts ofexpressing andtamingof drives. If the internalization ofparental object),andlaterthechild introjects (identification withfrustrating child’s response and repression toenvironmental frustration ofdrives results informationand of the structure of the self can be seen in Figure 3. If the self is relatively cohesive, then the man. These twomenrepresent the two poles of the structure of the self. These two poles nuclear selfandwhostrives beyond thepleasure principle,Kohut (1977)namesthetragic Kohut (1977)namestheguiltyman.Andonewhoseekstoexpress thepatternofhis of his self. The man who lives his life within the pleasure principle and his drive activities, two different directions, the direction of activity of his drives and the direction of fulfillment that ofconflict-drive psychology andthatofself-psychology. He seesman’s functioningin has itsown lineofdevelopment. This wasalsoimplicitlyargued by Lowen (1985). aspectofearlychildhoodconflicts. complementary Kohut (1971)arguesthatnarcissism of strength andpower, oressentiallyasreplicas oftheindividual.Narcissism isthusthe Lowen, sectionofhisbook“ intheintroductory Kohut (1977)arguesthatdepthpsychology requires approaches: twocomplementary Narcissism TOWARD ANINTEGRATIVE MODEL ” (1985,p.x), arguesthat the 61 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 62 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS He and hisfamilyimmigratedto the United States abouttwelve years ago. Sean’s father is a colleagueaboutyear ago. He hasabrother whoisaboutfouryears olderthanheis. nature ofconflictandself-psychologies.This casealsoillustratesthecomplementary of developmental neuroscience traumaandsupportive findings,especiallyshame,inanalysis. leaves itsimprintontheyoung humanbody. a shapethatisindicative ofthetraumasuffered, orlosescontactwiththebodyentirely. Trauma ortraumatized,of ahumanchildcontractsifchronically andmaintains andharshly frustrated Thus, theyalsoindicatethewayindividualmetabolizes energy. Similar toamoeba,thebody imprints are alsoindicatorsofthewayindividual’s energysystemfiltersimpulsesanddrives. understanding intothenature oftraumaitself, aswell astopointtreatment strategies. These traditional modelofcharacterstructure may needtobeaugmentedwithdisorders oftheself. significant disorders oftheselfthatneedtobeconsidered accordingly. In otherwords, our have suffered trauma(s).Imustagainemphasize thatmostclients,thesedays,domanifest oftheindividualwhomight handshakes, aswell asviscera,allspeaktoandofthepasthistory proper, expression ofeyes, facialexpression, toneofvoice, interpersonalinteractionssuchas general andbioenergeticanalysisinparticular, itiswell known thatposture, shapeofthebody imprints ofallthetraumasthatindividualhasendured. In mostsomatictherapiesin expression are limitedby thefunctioningandoperationofthisfilter. Thebodyproper has to theenvironment inawaythatismostadvantageous totheorganism,butmotilityand external orinternalemotionallycompetentstimuli. The individual,thus,isnotfree torespond that togetherwithitsneuralcorrelates, filtersthebehaviorofindividualin response to structure” (Reich, 1980;Lowen, 1971;Lowen, 1994). Characterstructure functionsasafilter One canthinkofthissumtotalasthedevelopmental trauma,whichisalsoknown as“character patterns ofbehaviorresulting ofdrives from andtheiradaptations. thesumtotal offrustration andblockedinvarious degrees.frustrated Thus, whenstudiedcloselyandcarefully, oneobserves self, there isaneedtodevelop thebasicselffunctions. therapeutic relationship, andClauer(2011)suggeststhatinthepresence ofaninsecure senseof Tonella ofrestoration (2011)alsodiscussestheimportance ofexpression oftheselfthrough the empathic approach inourwork thanever before, aselaboratedingreat detailby Hilton (2008). needs tobecomemore cohesive andintegrated, whichinturnnecessitatesamore relational and centered around integrationoffeelingsandsensationsthanrelease ofrepressed drives. The self their own. One can also perhaps theorize that our psychotherapeutic work needs to be more out thatintheabsenceofacohesive self, drives becomeisolatedandthuspowerful entitiesof client is prone to acting out, helped by weakening of muscular armor. Kohut (1977) points and emotionsmaynotbe integrated within the totality of hisorherpersonality. Thus this to seekever-continuing excitement inorder toavoid depression. This client’s senses,feelings, punishing superego, maybemore hauntedby asenseofemptinesswhichmotivates himorher older times. This clientwithdisorders oftheself, insteadofbeinghauntedby apunitive and afflicted with disorders of the self, as aware of feelings and sensations as the conflicted client of HOMAYOUN SHAHRI,PH.D., M.A. Of In course,onecannotexpectonlydrive tobefrustrated. reality, manydrives are Sean isa22-year old manwhowasborntoanaffluentfamilyand referred tome by In thefollowing casehistory, Iwilldiscusstheapplicationofproposed integrative model The imprints on the body resulting from developmental trauma can be studied to gain an The Case ofSean about his studies, despite the fact that he is a very brightman.Seanabout hisstudies,despitethefactthatheisavery hashadquiteafew marijuana atnight.At timesheattendedcollege,butnever didwell, andnever wasserious but didnothave muchanxiety. He wasspendingmostofthedaysleeping andsmoking of direction inlife,andnotknowing whathispassions are. He wasalsomildlydepressed, constant state of defiance. Sean’s presenting issues were lack of motivation, having no sense and avoided eye contact. Sean set jaw, has a very as if he which is is in slightly aforward, quietly, almostwhispering,andattimeshecovered hismouthwithhandashespoke man witharigidstructure. softlyandWhen hefirstcametomyoffice,spoke very by Sean as being depressed, which is concerning to him. Sean is a tall and handsome months atatime,foraslongSean remembers. His mother stayshomeandisdescribed a businessmanandtravels quiteoften.He hasbeenawayfrom hisfamily, sometimesfor became aware ofearlychildhoodmemories inwhichhehadtolift hismother’s moodby those whocared forhim, inorder tomaintainsomesenseofself. Over several sessionshe meaning ofhisoddbehavior thus becamecleartohim.He woulddisappoint andfrustrate merge withpeoplewholiked him,andthathewouldnotexistashimselfanymore! The he feltwasgoingtohappen. His response wasquiteinteresting. He saidhefeltwould anxiety inhisstomachand chest.IaskedSean tostaywiththosesensationsandseewhat of when someone was deeply fond of him. He said that he felt a strange sensation similar to many months,Ifelthewasready togodeeper. IaskedSean whatsensations hewasaware them, whichnearlygothimfired again. Having worked onhissensationsandfeelingsfor peopleinthecompany.a few He realized thathewasrepeating hispatternofdisappointing mentioned thathehadfoundajobseveral weeks ago,andthathehasbecomefriendswith monthsago,heexcitedlyA few cametoasessionafterabout month ofabsenceand and wasterminatedbecauseofthisbehavior, even thoughhismanagerwasfondofhim. But anddisappointingotherscontinued. He hisoddbehavioroffrustrating foundajob sense ofshamethathecarriedwithhimselffrom notlivinguptohisparents’ expectations. know whyheengagedinthisbehaviorofdisappointingotherswhowere nicetohim. with hisparents, friends,andeven collegeprofessors whowere kindtohim.He didnot session toprocess andanalyze it,anditbecameapparent toSean thatthisiswhathedoes pleasing role, onlytofollow itwithmore disappointment.Ibrought uphisbehaviorina like hisformertherapistdid).Interestingly, hewouldtakeona ashe feltmyfrustration, mesothatIwouldrejectmentioned, asifhewantedtodisappointandfrustrate him(just a strong bondwasdeveloping between Sean andme,hewouldbehave inthewaysthatI correlated withthebuildingoftherapeuticrelationship. In otherwords, anytimethat not show upatallwithoutcallingtoinformmeofhisabsence. This behaviorwashighly love. Asthework progressed, Sean begantoshow uplatetooursessions,andattimesdid found outlaterintherapythatsaying“NO”,tohim,meantpossiblelossofcontactand muchinhishead. very We alsohadtowork onsettingboundaries,andsaying“NO”.Sean breathing shallow. ashisbreathing wasvery We alsoworked ongrounding, asSean was by gettingSeanstarted tofeelhisbodyandbecomeaware ofhissensationsanddeepen much atall.He couldonly, andbarely, identifyifsomethingfeltgoodorbad.Our work Sean onthebodylevel. Initially hecouldnotfeelmuchinhisbody, andhewasnotfeeling and halfyears ofcognitive behavioraltherapybefore comingtomyoffice. relationships butindicatesthathehasnever loved Sean anyofhispartners. hadaboutone I worked very intenselywith Sean’sI worked very sensationsandfeelings.He becameaware ofadeep Therapy withSean slow. started working with beginningIstarted Almostfrom thevery TOWARD ANINTEGRATIVE MODEL 63 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 64 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS The importance ofshameinthe formationofdevelopmental traumawasalso discussed,The importance that, basedonthismodel,character structure could beviewedasdevelopmental trauma. neuroscience were presented theproposed integrative tosupport model,anditwasshown of drives, intheformofmusculararmor, were alsodiscussed. The latestfindings of of thechild.Somatic aspectsofthedefensive mechanismformaintainingtherepression are meant to affirm the child’s the mirroring, idealizing, or twinship needs self and serve the exciting aspects of thebad object(libidinalego),seekstheneededselfobjectswhich as internal saboteur.serving of the split impulse/drive,The second part corresponding to introjects (originoftheformationsuperego), havingantilibidinalcharacteristic,and the badobject,resulting inrepression oftheoriginaldrive/impulse andleading toparental andexcitingsplitting intofrustrating aspects. aspectofThe childidentifieswithfrustrating order tosurvive. The child theninternalizes thebadobject, which goes through further is alsosplitintwo:agoodobjectandbadobject. The childidealizes thegoodobjectin Simultaneously, object),itsplitsintwo parts. negativity (frustrating object thefrustrating (pleasure seekingorobjectseeking)inthechild,andmeetswithparental and frustration based onexistingones.Specifically, itwasarguedthatwhenadrive/impulse isformed the aforementioned schoolsofpsychology. The intentionwasnottosynthesizemodel anew relations, andself-psychology. The intentionwastopresent amodelthatbrought together attempted tointegrateegopsychology, drive-conflict theory, somaticpsychology, object me,butstayed withhim,helpinghimtofinallyseparatefromwhen hefrustrated hismom. withinthetherapeuticrelationship onmypart inthatIdidnotpushhimawayfrustration of self. inhistherapywasidealizationofmealongwithoptimalWhat wasalsocrucial on hisbodythatallowed Sean toslowly dissolve hisdefensesanddevelop adeepersense of hisfeelingsandemotionswithinthetherapeuticrelationship andtheconsistentwork him. And he tried hard, as he mentioned in one of his recent sessions. It was the containing therapeutic relationship inwhichSean couldfeelthat I,thetherapist,wouldnotabandon inthisclient’sinstrumental progress intherapy. wasbuildingthe Of equalimportance breathing exercises, grounding, andworking onintegratingsensationandfeelings,were the bodyandrelationship were alwaysatthecenter. The work withthebody, through indicated theneedtoengageinbothpsychology oftheselfandconflictpsychology, but conflicts are now which we are beginningtosurface, currently working on. Thiscaseclearly sensations andfeelingsinorder tostrengthen hissenseofself. Interestingly Sean’s Oedipal much more responsible inhislife.My work withSean wasmostlyconcentratedonhis thosewhoaredisappoints andfrustrates closetohimand/orfondofhim,andhasbecome in hislife,andplanstogobackcollegewhenhediscovers hispassions.He nolonger has beenabletomaintainhisjobforseveral months,hasfalleninlove forthefirsttime her againtoreceive contact…He wasstuckinaloop!Our work stillcontinues,butSean and thuslosecontact. This wasnotacceptabletotheyoung boy, andtherefore hepleased contact and love from her, only to have topushherawaymaintain some sense of self sense ofself. He wasstuckinamajordilemma.He hadtocheeruphismotherreceive herinorderwas disappointandfrustrate togetawayfrom her, sothathe couldhave some cheering herupandpleasingher. But thenshewouldnotletgoofhim.All hecoulddo HOMAYOUN SHAHRI,PH.D., M.A. In thispaper, anintegrative modelfordevelopmental traumawaspresented which Summary andConclusion Lowen, A.(1994). Lowen, A.(1985). Lowen, A.(1971). Kohut, H.(1987). 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New York, NY: Routledge. Patterns ofattachment:A Alachua,FL: 65 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 66 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Winnicott, D. W. (1990). Tonella, G.(2011). The self:itsfunctions,attachmentsandinteractions.In Handbook Siegel, D.(1999). The developing mind.New York, NY: Guilford Press. Schore, A.(1994).Affectregulation andtheoriginofself. New York, NY: Psychology Press. Reich, W.(1980). Porges, S.(2011). The polyvagal theory. New York, NY: W. W. Norton &Company. Porges, S.(2001). Ogden, P., Minton, K.,&Pain, C.(2006). Ogden, P., &Minton, K.(2000).Sensorimotor psychotherapy: onemethodforprocessing Marcher, L.&Fich, S.(2010). Main, M&Solomon, J.,(1990).In Greenberg, M. T., Cicchetti,D.,&Cummings, M. HOMAYOUN SHAHRI,PH.D., M.A. (Original work published1933) International Journal ofPsychophysiology, 42,123-146. Norton &Company. sensorimotorpsychotherapy.org/articles.html traumatic memory. Psychotherapy Sensorymotor Institute. Retrieved from http://www. muscular system. 160). The University ofChicagoPress: Chicago. (Eds.),. Attachment inthepreschool years: Theory, research, (pp. andintervention 121- of Bionergetic Analysis, V. Heinrich-Clauer (Ed.). Germany: Psychosozial-Verlag. The polyvagal theory: Character analysis Berkeley, CA:North Atlantic Books. Human nature. Bodyencyclopedia: aguidetopsychological functionsofthe (3rd ed.).New York, NY: Farrar, Straus andGiroux. phylogenetic substrates of a social nervous system. phylogeneticsubstratesofasocialnervous New York, NY: Routledge Press. Trauma andthebody. New York,NY: W. W. tradition. On the basisofhisexperiences with Zen, Fritz Perls played aleadingrole in psychology andbodypsychotherapy inparticular, theuseofmindfulnesshasacertain is becomingincreasingly widespread invarious psychotherapy methods.In humanistic reduction (2011), the inclusion of mindfulness as an essential factor in the healing process Dialectical Behaviour Therapy (1996)andJohn Kabat-Zinn’s mindfulness-basedstress © Author andUSABP/EABP. Reprints [email protected] Volume 13,Number 1,spring2014 International BodyPsychotherapy Journal soul andspirit,consciousness-centred bodypsychotherapy. patternsofexperience. transcends thecustomary one’s own canbedirectly existencenewly perceived andexperienced. This condition ‘awareness’ candevelop withaltered perceptive andexperientialqualitiesthrough which non-religious contextofchangeprocesses. In thelaterstagesofindividuationtherapy, the Eastern(especiallyBuddhist) schoolinginconsciousnessandintroduced intothe are toaccompanythepatient’s therapy. This attitudewasborrowed pragmatically from is basedonanattitudeofmindfulnessanditsrelated process —awareness —which neuroscience, psychotherapy, andinfantresearch are integrated. This wayofworking individuation are linkedtogether. and from Plausible explanationsfrom cultural history The holisticapproach describedhere isamethod inwhichtherapyandtheprocess of psychotherapy decisively achieves anawareness interventions, forthehere andnow. of thefirstsessiontherapywithapsychosomatic patientwho,withthehelpofbody phaseoftherapy.patient andtheparticular To demonstratethis,atranscriptisincluded forthedevelopment ofconsciousnessdependingonthestructureopportunity ofthe changeinestablishedpatternsofexperienceandbehaviour.meaningful It alsooffers of abasicspiritualtrainingwiththetherapeuticprocess canleadtosustainedand consciousness inadifferentiated mannerinbodypsychotherapy. The integration It isextremely valuable from aclinicalperspective tomakeuseoftheprocesses of With thethird wave ofbehaviouraltherapy anddevelopments suchasMarsha Linehan’s Keywords: Awareness andMindfulnessinConsciousness- mindfulness,awareness, development ofconsciousness,unitybody, Received 8February 2013;received inrevised form28June 2013; Translated from theGerman by Elizabeth Marshall Centred BodyPsychotherapy accepted andtranslationbeguninJuly 2013 ISSN 2169-4745Printing, ISSN2168-1279Online Christian Gottwald, MD The Art andScienceofSomaticPraxis Background Abstract AWARENESS ANDMINDFULNESS 67 67 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS CHRISTIAN GOTTWALD, MD AWARENESS AND MINDFULNESS

introducing “awareness” into Gestalt therapy (Perls, 1976). By the same token, Ron Kurtz von Kues, Johannes Tauler). The background and various aspects of what I am describing (2000) eclectically and pragmatically adopted the “mindfulness” practice as seen in Taoist here as a scientifically plausible, methodically integrated approach to working with change meditation to support the therapy process of his Hakomi method. Gendlin focussed on the processes in therapy and individuation have been comprehensively described elsewhere relationship of mindfulness to the body with his “felt sense” (1992, 1997). There are many (Barrat, 2012; Gottwald, 2004a, 2004b, 2007a, 2007b, 2010a, 2010b; Kurtz, 2002; Pesso more therapy forms that centre on mindfulness, for example, mindfulness-based cognitive & Perquin, 2008). therapy (MBCT) and Acceptance and Commitment Therapy (Halko Weiss & Michael Harrer, 2010). In the consciousness-centred body psychotherapy approach to supporting change in Arriving in the Here and Now therapy and individuation work described here, mindfulness and, significantly, awareness As we see in the following case study with a completely inexperienced psychosomatic as a continuing quality of existence and consciousness, are encouraged and facilitated. patient, clients must first become aware of the present moment. This is why they are invited, This contribution is meant to stimulate discussion around a differentiated initiation and preferably right from the start, to experience the present in full awareness of all that their supervision of consciousness processes in body psychotherapy. For each of the stages of consciousnesses can perceive. The focus is on the body as the incarnated mind-soul, which is therapy, consciousness of the here and now, as well as mindfulness and awareness, can be in contact with the environment that is perceived through the body. THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

introduced and practiced. The approach to these states of consciousness that is espoused in In consciousness-oriented body psychotherapy, by now there are a host of interventions this paper will be illustrated through a case study later. that help patients, clients, and students become aware of the elements of their experiences of Vital insights of neurobiological research will be taken into consideration when dealing both the body and the emotional sphere in its entirety. In the initial phases of therapy, it can specifically with consciousness processes in the framework of body psychotherapy (Damasio, be possible in some cases through body psychotherapy interventions to actively help patients 1996, 1999; Davidson et al. 2003; Hüther, 2003; LeDoux, 1996, 2001, 2003; Beutel, 2003, become aware of the present moment and gradually perceive their own bodies (ensouled 2008; Singer & Ricard, 2005). bodies) more consciously. This can be facilitated by intensifying the strength of the stimulus 1) Mindfulness is very beneficial for change and learning. Mindfulness and awareness are of the internal signals (somatic markers), through, for example, bio-energetic stress positions, variations of the state of consciousness known as attention. Ott (2008, 2010) provides an increase in generated breathing, and the use of voice. a comprehensive literature on the scientific research into mindfulness and meditation. 2) Only in the present can one access and influence the experience and behaviour Case Study: Mr. A patterns of our body/soul/spirit, which are established in the nervous system. A Mr. A is an intelligent, 57-year-old man who comes from a simple background and plausible consequence of this is that consciousness of the here and now is essential for suffers from depressive moods and neuropathic paraesthesia of the hands and feet, which he change processes and should be the focus of therapy from the beginning. experiences as extremely threatening and which tends him towards hypochondria. After an 3) The world we experience is a subjective reality, created in each moment by the initial interview and a brief overview of his history, he comes in for his first session. Having nervous system. Signals from the outside world are transformed in the neurons into broken off several previous treatments, he is very sceptical; it seems particularly important in electro-chemical signals and in the synapses into neurotransmitter signals. From this his case that he should have a different experience in this first session, so the therapist decides abundance of signals one develops the impression of oneself and the world, which one to take a very active approach. then experiences as objective truth. The patterns of these perceptions, experiences,

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL and behaviours occur automatically and without voluntary participation. They have Transcript of the First Body Psychotherapy Session JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL a fixed, repetitive structure and thus ensure the continuity of self-experience but (The figures represent the minutes and seconds of the session. Explanations and comments thereby determine a limited perception of present reality. are in italics and parentheses. Pauses are indicated by ellipses.) The fact that self-experience is imprinted by history and is subjective and not directly in contact with external reality can unfortunately lead to extremely painful consequences. It is 1:01 Therapist: How have you been since our first meeting? common to have no spontaneous awareness of or distance from this process and to believe A: What should I say, doctor? I still don’t know whether I’m in good hands with you. I tell that one’s experience of reality is the truth. This subjective impression of oneself and of the you this quite honestly. I’ve trusted other therapists so often and none of it has really helped. world can be perceived and experienced in a more differentiated way through appropriate I’m ambitious and I want to achieve things. I always wanted to get on and, really, I wanted consciousness training and through experiencing the body and body contact. to study, but circumstances always put obstacles in my path. A holistic understanding of healing that is based on the scientifically proven unity of body, 1:31 Therapist (who has already taken a detailed history, tries a very active intervention): Would it be all soul, and spirit (summary in Niedenthal, 2005) strongly suggests incorporating cultural, right if I challenge you a bit? (A agrees.) I’m convinced that it wouldn’t help you much if you just repeat historical, and philosophical motifs from antiquity. In the Greek asclepeia, for example, the these stories, which you know so well anyway, and which you’ve already at least told me in part. unity of body, soul, and spirit was taken for granted in the collaboration between priests 1:37 A (cleverly interrupting the therapist): So it would be better to plan for the future! and physicians. Buddhism has, as well shown in countless cases over 2500 years, the value (Evidently, he has been asked to do this in earlier treatments.) of offering consciousness training for laypersons. With a holistic understanding of healing 1:44 Therapist: No, that’s not what I mean. First and foremost, what would help you most enriched by elements of this basic training, we can find a connection to our own Western in my opinion would be to arrive in the present! Therefore my first question would be:what mystical tradition (for example, in the German language sphere, Meister Eckhart, Nikolaus do you notice at the moment… here and now? 68 69 CHRISTIAN GOTTWALD, MD AWARENESS AND MINDFULNESS

2:00 A: What do I notice at the moment? I feel these symptoms. this tendency? 2:10 Therapist: What do you feel and where do you feel it exactly? 5:22 A. Yes, I do! 2:10 A: It feels as if my shoes are making my feet numb. And my feet are very cold. 5:29 Therapist: Can I just explain a little about some basic neurobiological principles? (A 2:20 Therapist: According to the diagnoses you brought with you, you do in fact experience nods.) What we focus our attention on becomes larger and what we withdraw our attention both paraesthesia and cold feet, both of which could be due to the diabetes mellitus you have. from becomes smaller. This means that you are repeatedly less aware of what works well in (It is important to acknowledge the somatic and neuropathic dysesthesia from the start.) But the your body and that instead you focus on what is not so pleasant, what doesn’t work so well. rest of the problem could depend on how you deal with these sensations, how you cope with (The therapist emphasises the psychological explanation with gestures, showing how these aspects them. grow ever larger.) 2:56 A: Possibly! 6:02 A: You’re right there! My brain directs my attention towards something unpleasant, 3:02 Therapist: Thousands of people have the same physical condition, but everyone reacts something negative. But you know… sometimes I have a good moment, but then it starts differently to it. We should try to find out what is exactly happening in the present that up again! unsettles you so much. (A agrees.) 6:35 Therapist: And it goes on so that by force of habit you’re virtually drawn to the THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

3:12 Therapist: What do you notice is happening just now? unpleasant signals, for example, the painful sensations in the feet… Could this be the case? 3:15 A: What’s happening now? I already told you that before… 6:47 A: Yes it could. I’m afraid that it could be something really organically wrong. 3:17 Therapist (actively confronting A again): But you’re going back into the past again! 6:57 Therapist (using his authority as a specialist): There is probably some organic malfunction, The question is what’s happening to you now. such as tiny changes in the nerves caused by your diabetes. Something like that could trigger 3:25 A: It was a great shock for me when my wife died so suddenly. painful sensations. But these sensations are always psychosomatic: that means a part is 3:30 Therapist: But again you’re back in the past! What’s happening here and now in the organic, connected to the body, and another part is connected to the soul, with how that present? deals with the experience. But you can influence how you deal with these things. And of 3:36 A: In the present, I’ve just met a nice woman. course at 57 you’re not as young and in as good a condition as you were as a teenager. 3:42 Therapist: That’s the recent past… (Further explanation is required.) I’m trying to make 7:40 A: Yes, that’s true. you aware of the absolute, exact, present situation here in this room, in your body, do you 7:43 Therapist: But we can influence this at any age. I can help you to do this. That would see? This is the only moment we live in and which we can influence directly. The past, be the beginning of the therapy, when you notice more clearly how little you participate in including the recent past, is gone, we can’t change it any more. And the future isn’t here yet. your life in the present moment. Then, I could help you to pay more attention to what you May I continue insisting on calling your attention to the precise present moment? (A nods.) can perceive here and now. Would you agree to this? (A agrees.) Now I will ask you some 4:00 A: What do I notice now? questions that you might not be able to answer easily or quickly. I’ll start by asking you again: 4:03 Therapist: Yes, exactly — what do you notice, or what do you feel in your body and How are you feeling now? But the question is really: How are you feeling exactly in the here where, or what are you aware of through your senses? and now? What do you notice in the body? 4:08 A: You mean what’s bothering me? 7:58 A: How am I feeling now? Yes, I notice that I’m feeling better. (The responsiveness of the 4:13 Therapist: No, I mean something quite simple: do you notice that you are alive and that therapist has of course calmed A down a bit.)

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL you are living in the moment in your body? 8:03 Therapist: How do you notice this? JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL 4.15 A: Yes, I notice… that I’m alive. 8:10 A: Yes… my thoughts have gone somewhere else. I’m not thinking about my legs at the 4:17 Therapist: How do you notice that? moment. 4:20 A: Yes… I’m breathing. (This sounds more cognitive.) 8:20 Therapist: Isn’t that interesting? What else do you notice? How do you notice if 4:21 Therapist: Do you notice how you’re breathing just now? something is better? What is going on now in your body, while you’re not following 4:24 A: Maybe not. your thoughts in their usual direction? 4:28 Therapist: It seems quite possible that this simple experience of breathing as well as the 8:39 A: I notice that I’m more relaxed. many other functions of your body may go on with you hardly noticing. 8:41 Therapist: How do you notice that you’re more relaxed? Where do you notice that 4:31 A: Yes, actually, that’s true. I notice what’s not working, but I don’t take any notice of in the body? what works well. (A becomes thoughtful.) 8:46 A: Perhaps the heartbeat? 4:45 Therapist: That’s possibly it. So what do you notice spontaneously in your body now 8:48 Therapist: But that’s probably again something you’re thinking about! What I’m asking and also through the senses… beyond the sensations in the foot? Try to be open about what’s is what you perceive directly. How and where in the body do you notice that you’re going on in your body apart from that. maybe a little more relaxed? 4:56 A: Yes, exactly, for example my digestive system is functioning well…but… (Again, this 9:03 A: What should I say? What I notice now? (A is at a loss). is cognition, not experience.) 9:07 Therapist (A needs perhaps more help and guidance in his bewilderment): I can understand 5:08 Therapist: Notice what’s just happening: you mention something that functions that you’re perhaps not used to paying attention directly to the body. Until now, you’ve really well and in the next moment, with much more emphasis, you say “but”! Do you notice only been aware of the body through bad sensations. Maybe you need more help in noticing 70 71 CHRISTIAN GOTTWALD, MD AWARENESS AND MINDFULNESS

and becoming aware of yourself in your body. Then you could perhaps realise that you have a breathing? Now I’d like to invite you to squat down lower, let the breathing gradually become life beyond these bad sensations. Up until now, it’s probably been very difficult to really feel deeper, and allow the voice to join in as a sigh. (Including the voice tends to make breathing this vital life of the body through the bad sensations. easier and deeper). 9:40 A: I do notice somehow that I’m alive, but how?! … (A is becoming increasingly quieter 15:01 Therapist: I’ll show you how to do it. (The therapist demonstrates an audible sigh.) In and more thoughtful.) Up until now I’ve been concentrating on the negative aspects!!!! this way your breathing could become deeper and deeper if you will let it. 10:15 Therapist: Shall we continue practising this perception of the body in the present 15:02 A: (Slowly A begins to breathe more deeply and to make his breathing audible.) Ah, yes!… moment? (A nods slightly.) (In the end he can’t keep up the low squat position and stands up straight. The therapist does the 10:40 A: If I pay attention to it, I notice that I’m breathing. same as it seems that there is adequate stimulation of the patient’s breathing.) 10:53 Therapist: Very good, would you like to stay with this experience of breathing? 16:03 Therapist: Let yourself notice what is happening now that you’ve done that. 11:02 A: But you know…. 16:15 A: I feel as if I’m heavier now. 11:04 Therapist (in view of the good working alliance, interrupting A before he can fall back 16:17 Therapist: Exactly! Now you can notice how heavy your body is! into his usual cognitive mode): Do you notice how you’re just about to move away from direct 16:20 A: That’s it!… I feel heavier. And I notice that I’m standing more… firmly on the THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

experience now? ground. 11:07 A: Oh, yes…exactly! ... 16:25 Therapist (marking the changes): You notice that your contact with the ground has 11:12 Therapist: Could it be that you find this simple experience of the living breath in the improved?! here and now dull? Most people do. 16:33 Therapist (deciding to reinforce the perceptible changes in this first session, so as to bring 11:59 A: But why is that? … Does it all have to do with my past and all that? … I had some A more strongly into contact with his breath power, “chi”, his aggressive potential): If you like, I very bad experiences! (A refers to general knowledge of depth psychology he has garnered from could show you a second exercise from a martial arts school, which trains the breath power earlier therapies.) and which should be challenging for us both. (A agrees. The therapist stretches his arms out in 12:08 Therapist: Yes, in the course of our lives we do in fact learn these habits of guiding our front of him and offers his hands to A at about shoulder height. Then he invites A to stretch his attention to certain things. It’s good to be aware of this. But it’s not really helping you in the arms out at shoulder height and to grasp the hands of the therapist.) Now I’ll try to push you present, when you have such pain, to concentrate on it and worry about it so much. towards the wall behind you. You resist me as strongly as possible, so that I can’t move you. 12:35 A: But I had too many negative experiences in the past… That’s why I always expect (The therapist pushes A, who is very strong but who resists only slightly, backwards. Afterward he negative things to happen. (A slaps his thigh.) invites A to push him back in the other direction.) 12:48 Therapist: Then it can easily happen that you leap from this difficult past into the 16:54 (A stops breathing while trying to push the therapist backwards, which prevents him from future and expect similar experiences there. (The therapist demonstrates and underscores this doing so effectively.) with the left hand symbolising the past underneath and the right hand symbolising the future 17:02 Therapist (drawing A’s attention to the constriction in his breathing and showing him how high above). But the only moment in which we are alive is here and now! (The therapist much more difficult it would be for the therapist to push A back without breathing. Then he shows demonstrates this through body language with the arms crossed at the centre.) But many patients, A what happens when he uses his imagination to send the breath through his arms and breathes just like you, find it difficult to be conscious of most of the aspects of the present. freely. In this way, he can push the patient backwards with no effort at all): In the course of the

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL 13:15 A: So I have to learn to live now today?! psychotherapy you can learn and improve this skill of expanding and extending the breath. JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL 13:18 Therapist: Absolutely! In any case, it would be good if you became more aware of Shall we try it again now? (A agrees.) sensations and experiences in the present. Otherwise, you could very easily be so absorbed 17:30 Therapist: Now push me back to the wall with your breath, your life energy. in the pain in your feet that you leap into the future with all the fears and or fall back into 17:35 (By utilising his breath and his voice, A actually manages to push the therapist to the wall thoughts and worries from the past… (A seems more present and nods his head). and is obviously enjoying himself.) 13:46 Therapist (thinking that as A has had great difficulty in becoming conscious of himself 17:41 (As A is breathing deeply, this is a good moment to let him feel what’s happening.) Therapist: in his body, a body psychotherapy intervention could reinforce the strength of the physiological Now feel again what you’re experiencing in the body at the present moment after we did signals): We could now try to strengthen the signals from your body with a little body this experiment together. exercise. It would probably make it easier for you to feel more clearly what else is going 17:48 A: My breathing is deeper!… Yes, it’s really an improvement... Yes, the breathing is on in the body apart from the pain in your feet. Would you like to try it? (A agrees.) much deeper. (A is astonished and obviously very relieved and happy.) 14:01 (The therapist stands up and invites A to do the same. The therapist moves the chairs away. 17:57 Therapist: How is it for you to feel yourself in the body like that? Then he squats down low with legs apart and invites A again to take up the same position, which 18:05 A (laughing): Oh, so this is what it’s like to breathe properly!! he does willingly.) 18:14 Therapist: Maybe now you can be more aware of what a strong man you are… How 14:21 Therapist (while he and A are squatting, motioning that sooner or later the thighs will is this quality for you just now? start to hurt): When the pain comes just let it be there. (The patient breathes very shallowly at 18:35 A: Yes... When I move vigorously … (Through the experiences A just made, he is having first). Try to relax as much as you can. And if possible try to make a sound with the breathing, insights which have real meaning for him.) perhaps with an audible sigh on the out-breath. Do you notice the shallowness of your 18:46 A (very thoughtfully): … Yes, it’s true… Yes, funny when I do yoga — sometimes I do 72 73 CHRISTIAN GOTTWALD, MD AWARENESS AND MINDFULNESS

yoga — when I breathe more deeply, I calm down! Since basically every present event is considered to be an embodied experiment on a (These spontaneous insights are related to resources that the patient has already developed. mutual playing field, experienced in all its ramifications, this experiment can be corrected Therefore the therapist decides to provide some more information. He explains the Eastern concept at any time. According to the situation, therapist and client can consciously create new of “prana” and points out that the Hebrew word “ruach” also means the breath of life that God experiences together. This experimental (and therefore in principle, scientific) understanding has breathed into the human being. A listens, intrigued. Finally, the therapist demonstrates allows for a highly creative and custom-fitted approach to interactions. what further possibilities there are in body psychotherapy for becoming more aware of the present Sessions of consciousness-oriented body psychotherapy seem at first glance very different condition of the body, feeling more at ease in the body, and experiencing one’s own energy flow. He from each other, although the basic principles could be named at any time. All the options shows A, for example, that he is not standing in the centre line and that he is over-extending his from the previous experiences of patients, clients, students, and of the therapist (including knees when he stands.) various methodical backgrounds, especially from body therapy and body psychotherapy) 23:37 Therapist: Shall we arrive again in this new present moment? (A agrees.) What do can be included, tested, and integrated. For a clinical, psychosomatic (body psychotherapy) you notice now? practice, the use of mindfulness in such an experimental manner can become a fundamental 23:39 A: Very good… I notice that now I really do have more energy. component of an integrated, structural way of working that utilises various methods and THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

23:46 Therapist (despite the fact that that was a relatively diffuse perception, still feeling that it which allows the inner space of the psyche to be expanded and experienced in a more should be marked): Exactly, you notice now how much more energy you have. differentiated way. In this respect, we could speak of a psycho-soma-noetic practice (the 23:52 A (very thoughtfully): Yes, yes. That’s true. (He laughs and his face is glowing.) Greek word “nous” meaning mind-consciousness). (In the rest of the session, A asks about a diagram, the so-called growth-energy-spiral, which hangs Such change processes become obvious in the mindful awareness of the psychodynamic, in the offices. It illustrates the cyclic interaction between two people. With the help of this energy- historical background of previous patterns of experiencing and behaviour and the corresponding growth-spiral, A reflects on the process he has just experienced and relates it to his life. He also representations of self and object. Together we can create corrective responses, experiences, talks to the therapist about what consequences these ideas and experiences could have for his life. and (of course bodily and otherwise) interactions for traumatic or deprived states of self and Subsequently he mentions that after he has participated in a sport, he tends to return to early deficits. Through inclusion of the body in therapy, historical experiences can be worked concentrating on the pain in his feet. The therapist and A then go through the possibilities of through in a healing manner. These new holistic experiences can be internalised and may guided attention once more.) later help patients support themselves adequately. Additionally, clients are introduced to the 39:05 A: Yes, I understand that now… Super! When can we have another session? royal road to change in life and in consciousness.

Deepening Mindfulness in Later Phases of the Change Process Direct Experience: Awareness as the Training of Consciousness With a Direct Potential As patients gradually achieve an awareness of the here and now, we can help them to for Change in Body Psychotherapy become more conscious of their own bodies by asking again and again about the basis in the In the therapy phase (even before individuation work), patients can be encouraged in a body of each pattern of experience. (“Where do you notice that in the body? Where do you suitable moment not only to stop the unfolding of a pattern, but also to let go of all activity get the information from the body for this feeling? How does that feel in the body?) in that moment of awareness. The corresponding state of embodied perception, which is Later, therapists can reduce their activity and explanations. The patients can achieve a connected to a certain quality of existence, can be best termed “awareness”. It signifies the

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL deeper awareness of the present and learn mindfulness more independently. This state of opening of an inner, embodied “room of experience” in which we accept all that appears, JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL consciousness means maintaining a conscious, attentive, accepting attitude towards all that change nothing, and simply marvel. When individuation reaches an advanced stage, states arises in the mind moment by moment. of self arise, which different therapeutic approaches name and describe in various ways. Basically, mindfulness can be practised in two ways: as a one-off exercise, and as an Winnicott,(1983) for example, speaks of the “true self”, Dürckheim (1975) in the line of attitude of mind that is practised and encouraged in the ongoing therapeutic process. The Husserl (1913) and Medard Boss (1975) of” being”, and Assagioli (1965) of the “higher Hakomi method has integrated such a concomitant form of inner mindfulness into the field self”. of psychotherapy. In this process, the patients, clients, and students learn to consciously In such states, we can succeed in dis-identifying ourselves with those historically experience the present as an experiment and also to create experiments themselves, which determined automatisms that are spontaneously invoked by the brain. If patterns that are they then follow attentively, expressing their present experiences as they are had in a mindful deeply embedded in the body start to change or dissolve, existential experiences sometimes way. They perceive themselves in all their various, multifaceted aspects and speak at the develop that fundamentally transcend the historically determined personality. Such same time from this experience without losing the connection to the present moment. This transformations can be experienced as extremely impressive and surprising events in the allows the therapist to participate directly in the events of this inner life, communicating evolution and development of the personality, and, beyond all previous expectations and simultaneously, and so support the process appropriately. Therapists can encourage patients perspectives, even as a miracle. Similar states of experience are described in spiritual systems: and students to slow down the spontaneously emerging pattern of experience and behaviour, in mysticism as “awareness”, in yoga as “samadhi” (Zimmer, 1973), and in Tibetan Buddhism or to stop for a moment. Patients increasingly become the experts on their own worlds. as “rigpa” (Dalai Lama, 2001). In these cases, they happen spontaneously but usually after Supporting the process becomes increasingly subtle. Such processes sometimes feel like a long meditation. We can systematically increase the probability of such transformations in joint meditation. the non-religious context of body psychotherapy change processes through the appropriate 74 75 CHRISTIAN GOTTWALD, MD AWARENESS AND MINDFULNESS

support. Our experience as therapists leads us to advocate the training of consciousness and BIOGRAPHY an existential mindset not only in spiritual schools and systems, but also in therapy and Dr. Christian Gottwald is a physician and consultant for psychosomatic medicine, individuation work. We can take the responsibility for such a step, as in a consciousness-oriented psychotherapy, and psychoanalysis, as well as for neurology and psychiatry. He is a teaching body psychotherapy such as the Hakomi method (Ron Kurtz, 2002), which also understood analyst and supervisor. He was a postdoctoral research fellow at the University Clinic and simultaneously as an experiment, and the effects can be noticed and corrected at any point. Director of the University Polyclinic for Psychotherapy in Mainz. He was trained in Gestalt Patients with no previous knowledge may find it trivial to directly experience and be Therapy, Organismic Psychotherapy, Hakomi, Experiential Psychotherapy, and the Pesso aware of the present moment beyond the usual patterns of perception. But awareness requires Boyden System Psychomotor, and has had further training in other methods of humanistic a subtle reorientation not only of perception but also of the fundamental attitude toward psychology. As a teacher and trainer, he is a member of the teaching staff of the Hakomi the phenomena of the experienced world, which can be more and more differentiated. At Institute of Europe. He has worked in his own practice for individual and group therapy first, it is easiest to understand only theoretically that the separation between subject and in Munich with a specialty in consciousness-oriented body psychotherapy. He also works object disappears in pure awareness and that there is a non-dual form of perception and in coaching and team development. He has numerous publications on the subject of the existence. We can comprehend that there are different qualities of awareness: the quality of relationship between psychotherapy and brain research. THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

the awareness can vary, as well as the quantity of the processes of which we are aware. In this Email: [email protected] way, we can have a high level of awareness of cognitive processes but at the same time a low awareness of body sensations or feelings. REFERENCES In the therapy stage of the change process, with the help of consciousness-centred body Assagioli, R.(1965) Psychosynthesis. A Manual of Principles and Techniques, Hobbs, psychotherapy, a mindful state of consciousness can often become a gateway for spontaneous Dormann & Company, New York. spiritual experiences. This observation reinforces the idea of Fritz Perls (1976) and later Ron Barrat, B (2013). The Emergence of somatic psychology and bodymind therapy. Palgrave Kurtz (2002) of adopting and pragmatically integrating, from Buddhist spiritual training Macmillan, Hampshire and meditation, the development of awareness and mindfulness as a fundamental education Beutel, M.E., Stern, E, & Silberzweig, D. A. (2003). The emerging dialogue between in change processes. Apart from the “felt sense” of Focusing (Gendlin, 1997), it seems wise psychoanalysis and neuroscience: Neuroimaging Perspectives. Journal of the American to include other impulses, especially the fundamental attitude, from Eastern consciousness Psychoanalytic Association 51: 773–801. training, to differentiate mindfulness even further and to initiate systematic changes in Beutel, M.E. (2008). Vom Nutzen der bisherigen neurobiologischen Forschung für die perceptive and being qualities. In individuation work, which is inspired by this, it can become Praxis der Psychotherapie. (The usefulness of neurobiological research for the practice of clearer how in everyday consciousness, cognitive processes and thought chains usually play a psychotherapy). Psychotherapeutenjournal 8: 384–392 part in and affect how we are feeling. Thus, we teach patients, clients, and students, as a first Boss, M. (1975) Grundriss der Medizin und der Psychologie [An outline of medicine and step, how to become aware of their thoughts as such, then how to stop them, and later how psychology]. Huber, Bern, Stuttgart. to distance themselves subtly from these chains of thought without either repressing them or Dalai Lama (2001) Dzogchen - Die Herz-Essenz der Großen Vollkommenheit [The heart being absorbed by them. essence of Perfection]. Theseus, Berlin. Increasingly they learn to notice the quality of their thoughts and simultaneously their Damasio, A.R. (1996). The somatic marker hypothesis and the possible functions of the

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL basis in the body with all the senses and thus to become directly aware of all the elements of prefrontal cortex. Philosophical Transactions of the Royal Society, B: Biological. Sciences, JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL these cognitively interwoven experience patterns. In the process, impressions automatically 351, pp. 1413–1420. rise up out of the body cells, metaphorically speaking. We can embrace these qualities Damasio, A. & Kober, H. (1999). Ich fühle, also bin ich: Die Entschlüsselung des and learn to linger in them, to swim in them, while marvelling at the experience without Bewusstseins [I feel, therefore I am: The decoding of consciousness]. München: List wanting to influence or change anything. Just being able to stay with an experience creates a Verlag. significant difference in the quality of the world we live in, which means direct participation Davidson, R.J., Kabatt-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, in the experience and a subtle distancing from it at the same time. In this process we notice S.F., et al. (2003). Alterations in Brain and Immune Function Produced by mindfulness in an increasingly differentiated way how the experience changes from moment to moment. Meditation. Psychosomatic Medicine 65; 564–570. New creative ideas can come up intuitively, which can be extremely inspiring. Such states of Dürckheim, K. (1979) Transzendenz als Erfahrung. In: Gion Condrau (Hrsg.): Imagination, self transcend the historically determined patterns of experience and behaviour. In a spiritual Kreativität und Transzendenz (Die Psychologie des 20. Jahrhunderts. Bd. XV). Kindler- context, they would be characterised as ego-transcending experiences because they make Verlag, Zürich. one aware of one’s connection to the immediate environment and even to what one may Gendlin, E. T. (1992) Thinking beyond Patterns. Body, Language and Situations. In: B. den experience as the cosmic or divine whole. Strictly speaking, however, it is the systematic Ouden, M. development of the consciousness of a personality. Such an experience is usually only possible Moen (Ed.): “The Presence of Feeling in Thought”, New York, Peter Lang. after a longer preparation in therapy and individuation work. (For a relevant detailed case Gendlin, E. (1997) Experiencing and the Creation of Meaning. A Philosophical and history with transcript see Gottwald, 2012.) Psychological Approach to the Subjective. Northwestern University Press

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Gendlin E.T. (1998) Focusing-orientierte Psychotherapie. Ein Handbuch der Niedenthal PM, Barsalou LW et al. (2005) Embodiment in Attitudes, Social Perception and erlebensbezogenen Methode. (Focusing-oriented psychotherapy) Pfeiffer, München. Emotion. Personality and Social Psychology Review, 9;3 184-211 Gottwald, C. (2004a). Bewusstseinszentrierte Körperpsychotherapie (Consciousness centered Ott, U. (2008). Transpersonale Perspektiven in der Meditationsforschung. (Transpersonal body psychotherapy). In: Sulz, S., Schrenker, L. und C. Schricker (Hrsg.): Die Psychotherapie perspectives in meditation research) in: Transpersonale Psychologie und Psychotherapie. entdeckt den Körper (Psychotherapy discovers the body). München: CIP-Medien. Band 14, Heft 1, S. 75–82. Gottwald, C. (2004b). Bewusstseinszentrierte Körperpsychotherapie – Angewandte Ott, U. (2010). Meditationsforschung heute – Bilanz und Ausblick. (Meditation research Neurobiologie? [Conscious centered body psychotherapy – Applied neurobiology?]. today) in: Visionen. Psychotherapie Bd 9, Heft 2, Seite 185–218). München: CIPMedien. Heft 10, S. 10-13Perls, F.S. (1973/1976). Gestalttherapie in Aktion. (Gestalt therapy in Gottwald, C. (2007a). Von Neurobiologie inspirierte Erweiterung der psychodynamischen action) Stuttgart: Klett-Cotta. Praxeologie durch bewusstseinszentrierte Körperpsychotherapie. [The enhancement of Perls F. (1976) Gestalttherapie in Aktion. (Gestalt therapy in action) Stuttgart: Klett-Cotta psychodynamic practice through neurobiology]. Psychotherapie Forum15: 73–77, Wien Pesso, A., Perquin, L. (2008). Die Bühnen des Bewusstseins oder: werden wer wir wirklich New York: Springer. sind [Theatre of consciousness] München, CIP-Medien. THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

Gottwald, C. (2007 b). Eine körperpsychotherapeutische Sicht auf die Neurobiologie. [Body Singer, W., Ricard, A. (2005). Hirnforschung und Meditation [Brain research and psychotherapy perspectives on neurobiology]. Psychologische Medizin 4: 4–20, facultas- meditation]. Frankfurt am Main: Edition Unseld, Suhrkamp-Verlag. wuv, Wien. Weiss, H., Harrer, M. (2010). Achtsamkeit in der Psychotherapie [Mindfulness in Gottwald, C. (2008). Körpertherapie auf dem Boden von potenzialentfaltender psychotherapy] Psychotherapeutenjournal 9: 14–20. Gestalttherapie [Body therapy on the basis of Gestalt therapy – potential development]. Winnicott, D.W. (1983): Von der Kinderheilkunde zur Psychoanalyse [Through pediatrics to In: Hartmann-Kottek L., Strümpfel U. (Hrsg.) Gestalttherapie: Berlin, Heidelberg: psychoanalysis]. Stuttgart: Fischer . Springer. Zimmer,H. (1973) Yoga und Buddhismus. Indische Sphären [Yoga and Buddhism. Indian Gottwald, C. (2010a). Heilsame Begegnung in der Therapie- und Individuationsarbeit sphere) Indel, Frankfurt am Main. [Healing encounters in therapy and individuation work]. Psychologische Medizin 2: 26–35, facultas-wuv, Wien. Gottwald, C. (2010b). Hilfreiche Metaphern in der Therapie- und Individuationsarbeit [Helpful images for therapy and individuation work]. Psychologische Medizin, 4:37–42, facultas-wuv, Wien. Gottwald, C (2012): Dasein und Inspiration in unmittelbarer Erfahrung [Being and inspiration in direct Experience]. Psychologische Medizin, 4:70-76, Facultas- Universitätsverlag, Wien. Hüther, G. (2003). Die nutzungsabhängige Reorganisation neuronaler Verschaltungsmuster [The use dependent reorganisation of neuronal wiring patterns]. In: Schiepek G. (Hrsg.):

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Neurobiologie der Psychotherapie. Stuttgart: Schattauer. JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Husserl, E. (1913) Ideen zu einer reinen Phänomenologie und phänomenologischen Philosophie. Erstes Buch: Allgemeine Einführung in die reine Phänomenologie [Ideas: general introduction to pure phenomenology]. Max Niemeyer Verlag, Halle(Saale). Kabatt-Zinn, J. (2011). Gesund durch Meditation. Otto Wilhelm Barth, München (amerikanische Originalausgabe: Full Catastrophe Living, New York, 1990). Kurtz, R. (2002). Hakomi, eine körperorientierte Psychotherapie [Hakomi: a body-oriented Psychotherapy]. München: Kosel. Ledoux, J. (1996). The Emotional Brain: The mysterious underpinnings of emotional life. New York: Simon & Schuster. Ledoux, J. (2001). Das Gehirn und seine Wirklichkeit (The brain and its reality). München: dtv. Ledoux, J. (2003). Das Netz der Persönlichkeit – wie unser Selbst entsteht. Düsseldorf und Zürich: Walter Verlag. Synaptic Self: How Our Brains Become Who We Are. New York & London: Penguin. Linehan, M. (1996) Dialektisch Behaviorale Therapie der Borderline- Persönlichkeitsstörung [Cognitive-behavioral therapy of borderline personality disorder]. München: Cip-Medien

78 79 80 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS lives; challenges with ease (Bonanno, 2004). Peoplethese people seem to experience new bereavement willbeusedinaccordance withthesedefinitions. describes the situation of having experienced a loss. In grief, this article, mourning,and with grief, istheintrapsychic andinterpsychic process usedto copewithloss.Bereavement 1984; Corr, Nabe, &Corr, 2009).Mourning, thoughsometimes usedinterchangeably death, and bereavement, defines grief as the(Worden, personal reaction to loss 2009; Rando, changes toaperson’s life(Hooyman &Kramer, 2006). Thanatology, thestudyofdying, individuals cancreate thegriefprocess. alifethatsupports a life-longjourney. This, however, doesnotmeanthatpeopleneedalwayssuffer. Instead, that whichwasandbeready forthatwhichistocome” (Rando,1984,p. 17).Grief isalso response toaloss(Hooyman &Kramer, 2006;Rando,1984). It “allows ustoletgoof be tolive alifewithoutattachments sothere isnothingtolose. Grief istheusual, natural the consequencesofthatloss.In thatlight,theonlywaythentoavoid thepainoflosswould loves theriskoflosingthatpersonandsuffering orformsanattachmentwithanotherruns © Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 13,Number 1,spring2014 International BodyPsychotherapy Journal DYANA REISEN,MA,CT Supporting theCreation ofContinuing Bonds Aftera DeathLoss grief toaidinthecreation ofcontinuingbondswiththedeceased. framework isproposed forusingbodymemoriesby thoseexperiencinguncomplicated (Klass, 1993a,1993b;Rosenblatt, 1983).Because griefisasomaticprocess, atheoretical actuallycontinuetheirrelationships withthepeoplewhohavethat manysurvivors died (Freud, 1917/1957;Rando,1984; Worden, 2009).But over theyears, evidencehasshown deceased is essential to the mourning process and that remaining connected is pathological a prevailing among clinicians in view Western society that breaking attachments with the memories ofdeceasedloved onestoformcontinuingbonds.Historically, there hasbeen More specifically, thefocusisonwhyandhow bereaved individualscan usetheirbody attemptstobridgethegapbetween thanatologyandbodypsychotherapy.This article Many are abletoendure survivors the distress intheirdaily oflosswithoutdisruption Loss results from anevent thatisperceived tobenegative andthatcreates long-term Most peoplewillexperiencedeathandgriefatsomepointintheirlives. Anyone who Keywords: grief, death,continuingbonds,bodypsychotherapy, bodymemory A BodyPsychotherapy Approach to Received 12April 2013;acceptedOctober 2013 Helping theBodyGrieve: ISSN 2169-4745Printing, ISSN2168-1279Online Dyana Reisen, CT MA, The Art andScienceofSomaticPraxis Introduction Abstract changes precipitated by theloss.Grief withcomplicated therapyisappropriate forsurvivors are experiencinguncomplicatedgriefandare astheyadapttothe seekingaddedsupport anindividualwithcomplicatedgrief.and supporting Grief counselingis for mournerswho (2009) differentiates anindividualexperiencinguncomplicatedgrief between supporting Leaman, 2001;Horowitz, Wilner, Marmar, 1980; &Krupnick, Worden, 2009). Worden potentially impairingtheirfunctioning,are saidtohave complicatedgrief(Howarth, & without moving through themourningprocess towards reorganization andadaptation,thus which theliterature increasingly On theotherhand,thosewhogrieve indicatesisnottrue. becausenormalgriefimpliesthatsomeisabnormal,grief willbeusedinthisarticle normal grief(Rando,1984; Worden, 2009;Zisook &Shear, 2009). The termuncomplicated who are abletoadaptlossare considered by thanatologiststohave uncomplicatedor using theirbodies to get in touchwith theirmemoriesofthedeceased andcreate continuing body memory, will address this article how body psychotherapists mourners in can support their bodiesto create lastingrelationships withthosewhohave died.Using theconceptof ofwhyandhowpresenting individualsexperiencinguncomplicatedgriefcanuse atheory when working with someonewhohashadaloved onedie. relationship formationinbody psychotherapy, itseemsfundamental tousesuchanapproach form our relationships through and as our bodies. Because of the focus on emotion and Schore, 1994).In addition,thehumanbodydoesnotexistinisolation(Totton, 2003). We body inthattheyare experiencedinboth(Caldwell, 1997;Damasio, 1999;Pert, 1997; in beliefandfeeling” (Totton, p. 24).Emotions are therefore abletobridgethemindand manifest intheirbodyand,conversely, changesinthebodycananddofacilitate working withthemind,andviceversa (Totton, 2003).“[A]person’s beliefsandfeelings of beinghuman;whenworking withthebody, part and mind,isanimportant oneisalso n.d.; Totton, 2003,2005).In bodypsychotherapy, embodiment,theconnectionofbody of thebodyandmind(Caldwell, 1997;European AssociationforBodyPsychotherapy, working withthemourningprocess. This formoftherapytakesintoaccounttheinteractions address theneedsofgriever” (Rando,1984,pp. 85-86). “To ignore thesomaticaspectsofgriefinfavor ofthepsychological onesistoincompletely shouldbetailoredgrief reaction, totakeintoaccountthesefactors. andgriefinterventions therapy (Rando,1984).Furthermore, physiologicalfactorsare saidtoinfluenceaperson’s reactions are oftenthemainreason thatindividuals withcomplicatedgriefare referred to sleep, tightnessinthroat orchest,restlessness (Rando,1984; Worden, 2009).Somatic ofbreath, shortness inabilitytogastrointestinal disturbances,physicalexhaustion,crying, as well (Rando, 1984). Some of themore commonphysiologicalmanifestationsofgrief are 2009). Althoughgriefisusuallyviewedasapsychological reaction, there are somaticreactions sensations, cognitions,andbehaviorsthatare commonafteraloss(Rando,1984; Worden, the griefresponse (Bauman, 2008).Normal griefiscomprisedof avariety offeelings,physical do notgrieve inthesameway. Nevertheless, there are commonelementsthatare evidentin this article. These distinctionsare beingnotedin order termsare togive contextforwhycertain usedin Stroebe, &Schut,2001)andwhentousegrieftherapyversus counseling(Worden, 2009). difficult tomake distinctions between normal andcomplicated grief (Stroebe, Hansson, mourning whoneedtoresolve conflictswith regard toseparationfrom thedeceased. It is This article will serve tobridgethegapbetween thanatology andbody psychotherapy willserve byThis article Since griefisasomaticexperience,bodypsychotherapy maybeausefulapproach to Grieving isanindividual experienceandeven iftwopeopleexperiencethesameloss,they HELPING THEBODY GRIEVE 81 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS DYANA REISEN, MA, CT HELPING THE BODY GRIEVE

bonds that involve their bodies. Body memory refers to implicit memory that is inherent Notably, Worden’s (1982) final task was originally to withdraw emotional energy from to the body and includes how we experience and remember life through the body (Casey, the deceased and reinvest it in another relationship. Worden (1991) later changed this task 2000; Koch, Fuchs, Summa, & Müller, 2012). Continuing bonds pertains to how “survivors due to further research that showed a large number of survivors stay connected with the loved construct a sense of the deceased and develop an inner representation of that person” one who died. (Silverman & Klass, 1996, p. 19). The shift in Worden’s (1982, 1991) grief model illustrates how new theoretical perspectives rejected the concept of breaking bonds with the deceased as a part of the Grief Theories resolution of grief. This came about because researchers began to discover that mourners were The study of grief began with Freud and his work on mourning and melancholia (Freud, continuing their relationships with those who had died long after their deaths. Numerous 1917/1957). Freud proposed that a person needed to work through the loss of a loved one studies revealed that survivors often feel a sense of presence of the deceased (Rosenblatt, who had died. He stated that mourning’s “function is to detach the survivor’s hopes and 1983; Silverman & Worden, 1993; Stroebe, Stroebe, & Domittner, 1988). Some studies memories from the dead” (Freud, 1917/1957, p. 257). Freud’s theoretical framework was found that bereaved parents maintain a continuing interaction with their deceased children later reinforced by Lindemann’s (1944) study that included people who had experienced the by creating inner representations of them (Klass, 1988, 1993a, 1993b). Fairbairn (1952) THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

death of a loved one in the Cocoanut Grove fire in Boston. From his research, Lindemann defined inner representation as “aspects of the self that are actualized in the interaction with (1944) concluded that grief work, the process of coping with a significant loss, required the the deceased person; characterizations or thematic memories of the deceased; and emotional bereaved person to confront the reality of the loss and detach from the deceased in order to states connected with those parts of the self and with those characterizations and memories” build new relationships. (as cited in Klass, 1993a, p. 344). In addition, other researchers discovered that many One theory that became well known and accepted was Elisabeth Kübler-Ross’ grief widows maintain an active connection with their spouses through a sense of presence of theory. In her book, On Death and Dying (1969), Kübler-Ross introduced the five stages of the deceased (Glick, Weiss, & Parkes, 1974; Shuchter, 1986). Because the modern Western dying. These stages were presented as a normal response to one’s own death. The process, world has moved toward a more individualistic view of the self, it is difficult for grievers to which is familiar to many people, starts with denial and progresses to anger, bargaining, feel supported in creating lasting connections with those who die (Stroebe, Gergen, Gergen, depression, and acceptance. Even though Kübler-Ross’ stages were based on people who were & Stroebe, 1992). Many other cultures believe that the deceased continue to live on in some dying, they have been applied to mourning survivors as well. Rando (1993) also contributed form after death and create rituals that sustain relationships with the dead (Silverman & to the stage theory of grief. Rando’s model, the six “R” processes of mourning, suggested that Silverman, 1979). Therefore, it is important for therapists working with bereaved individuals mourning has six phases: recognize, react, recollect, readjust, relinquish, and reinvent. This to be knowledgeable about and sensitive to how different cultures and religions may impact model is rooted in Lindemann’s (1944) concept of grief work. Thus, Rando (1993) theorized a person’s grief journey. that a bereaved person needed to sever ties with the person who died by relinquishing old attachments to the deceased and readjusting to the new world and creating new relationships. Somatic Components of Grief Despite its popularity, limited empirical research has been done on the stage theory of As mentioned earlier, there are various components of a grief reaction: physical grief. The studies of stage theory show mixed support for Kübler-Ross’s model. One study did sensations, behaviors, cognitions and emotions. Of importance to this article in particular not find any support for the stage model (Barrett & Schneweis, 1981), whereas other research are the physical or somatic manifestations that are associated with grief. Many researchers

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL found limited supporting evidence (Holland & Neimeyer, 2010; Maciejewski, Zhang, Block, have studied the reactions of grief and found that bereaved individuals report experiencing JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL & Prigerson, 2007; Meuser & Marwit, 2001). In addition to the lack of research that supports physical manifestations, such as changes in sleep or appetite, after their loved ones’ deaths the existence of stages in the grief process, there is also no agreement among thanatologists on (Kowalski & Bondmass, 2008; Lindemann, 1944; Parkes, 1964; Parkes & Brown, 1972; what the stages of grief actually are (see Dillenburger & Keenan, 2005). Zisook, DeVaul, & Click, 1982). Other studies on the somatic impact of bereavement Breaking away from grief stages, Worden (1982) adopted a different approach to loss have used biochemical measures to determine what happens to an individual’s body while by developing a task model of mourning. He stated that stages or “phases imply a certain undergoing grief. Some researchers have found that people who have experienced the death passivity” (p. 38) and the tasks concept implies that the mourner can and needs to do of a loved one have impaired endocrine functioning (Hofer, Wolff, Friedman, & Mason, something to actively adapt to the death of their loved one. In other words, the bereaved 1972a; Hofer, Wolff, Friedman, & Mason, 1972b). Furthermore, research has shown that person is given some control over their grief process. Although these tasks do not have to be survivors may experience dysfunction in their immune systems (Schleifer, Keller, Camerino, done in order, there is some sequencing in their definitions. Worden’s (2009) current tasks Thornton, & Stein, 1983; Spratt & Denney, 1991; Zisook et al., 1994). are the following: Despite studies that indicate there are physiological changes that occur when someone • To accept the reality of the loss is grieving, the physical sensations that accompany grief are often overlooked (Worden, • To process the pain of grief 2009). None of the aforementioned studies on the somatic components of grief suggested • To adjust to a world without the deceased ways to address such concerns. In grief literature, the physical issues are usually addressed • To find an enduring connection with the deceased in the midst of embarking on a only as a means to rule out any physical disease the grieving person may have (Rando, new life. 1984; Worden, 2009).

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Body Psychotherapy and Grief Theory: How Body Memory Can Inform Continuing Bonds Because grief is such a somatic experience, somatic psychology can be a useful modality Grief is a somatic process — people experience it through their bodies. Researchers when working with someone who is bereaved. However, there is minimal literature on have shown that survivors may exhibit numerous physical manifestations following a loss body psychotherapy and grief. Some of the major authors in somatic psychology do not (Kowalski & Bondmass, 2008; Lindemann, 1944; Parkes, 1964; Parkes & Brown, 1972; do anything more than mention grief in a list of emotions or in passing (Heller, 2012; Zisook, DeVaul, & Click, 1982). Furthermore, emotions are experienced in both the brain Lowen, 1972; Totton, 2003, 2005). Even when grief is discussed at length, the information and the body (Caldwell, 1997; Damasio, 1999; Pert, 1997; Schore, 1994). It therefore seems is more anecdotal and does not present theory or research to support the claims that are made apparent that the body can serve as a resource for mourners as they process their grief. One of (Keleman, 1975; Romanyshyn, 1998). the ways that this can be done is by using a person’s body memory of the deceased to create Many times when grief is discussed in the body psychotherapy literature, it is combined continuing bonds with the loved one who has died. with trauma (Minton, Ogden, & Pain, 2006; Ogden & Minton, 2000; Rothschild, 2000; van der Kolk, 1987). Grief is viewed as a response to a traumatic event and researchers Continuing Bonds often focus on unresolved grief. It is, however, important to separate grief and trauma. Continuing bonds reflect the efforts of the bereaved to preserve ongoing relationships THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

According to Stroebe, Schut, and Stroebe (1998), “it is possible to experience trauma without with the deceased and construct internal representations of them (Klass et al., 1996). This bereavement…and bereavement without trauma” (p. 83). The focus of this article will be theoretical approach proposes that it is normative for a person to maintain a connection with grief in the context of body psychotherapy without connecting it to trauma. However, it is the deceased. Instead of letting go, the emphasis is on creating and recreating the meaning of important to note that when trauma is a part of an individual’s grief experience, the trauma loss over time. Continuing bonds are not about living in the past or a failure to acknowledge needs to be worked through before the process of grief can begin (Lindemann, 1944). the death. They are actually a recognition of the bonds that, though formed in the past, can still influence a person’s present and future. Body Memory Creating continuing bonds with the deceased is a complex task that changes as the griever Body memory is a rather newly explored field. The concept of body memory emerged reconciles the loss. There are various ways in which people may maintain a relationship with the from cognitive research on explicit and implicit memory (Summa, Koch, Fuchs, & person who has died. These include dreaming, keeping belongings, talking with the deceased, Müller, 2012). Schacter (1987) stated that explicit memory stores experiences that can feeling a sense of presence of the deceased, visiting the grave, and frequently thinking of the be consciously recollected, whereas implicit memory stores experiences and the emotional person (Parkes, 1972; Shuchter, 1986). Certain expressions of continuing bonds are found to behavior connected to those experiences and is unavailable to conscious awareness. Body be adaptive, whereas others seem to create more distress for survivors. Field, Gao, and Paderna memory has been studied in cognitive science as implicit memory (Caldwell, 2012; Fuchs, (2005) propose that an important factor in determining if a continuing bond is adaptive is 2012). Phenomenology has also explored the concept of body memory (Casey, 2000; whether the given expression reflects a survivor’s attempt to create a more internalized and Fuchs, 2012; Sheets-Johnstone, 2012). Fuchs (2003) declares, “What we have acquired symbolically based connection that demonstrates an acceptance of the loss. Individuals who as skills, habits and experience, has become what we are today; implicit knowing is our maintained a more concrete tie and were not able to give up physical proximity to the deceased lived past” (p.2). Some phenomenologists have also differentiated various forms of body were believed to have more maladaptive relationships with the person who died. Furthermore, memory (see Casey, 2000; Fuchs, 2012). Koch (2012) empirically tested Fuchs’ divisions other researchers found that preserving a relationship with the deceased through their belongings

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL of body memory by doing a content analysis of interviews about differentiation of body was correlated with more distress over time, whereas creating a continuing bond through fond JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL memory. Results indicated that Fuchs’ categories were included by interviewees and were memories was not (Field, Nichols, Holen, & Horowitz, 1999). Nevertheless, Klass (1993a, further sub-divided as well. 1993b) discovered that linking objects provided solace to parents of the deceased, as well as Trauma researchers have also investigated how somatic memory and the body play a role validation that the children live on even though they have died. Linking objects and linking in trauma and post-traumatic stress disorder (Minton, Ogden, & Pain, 2006; Rothschild, phenomena are external objects or experiences that connect a person to the deceased, and 2000; van der Kolk, 1987). van der Kolk (1987) first talked about somatic memory in include examples such as a watch or a smell (Volkan, 1981). terms of trauma and asserted that unconscious memories of trauma are expressed as somatic symptoms. Despite body or somatic memory being supported in these fields, there is a gap Body Memory between body memory theory and research. Body memory is viewed as how people experience the world around them through their In addition to there being little research on body memory, the research on body memory bodies (Caldwell, 2012; Fuchs, 2012; Koch, 2012). It is dynamic in that it changes over time. and grief is even more limited. Hentz (2002, 2012) is the only person to have investigated As Fuchs notes, “body memory is our lived past” (2012, p. 11) because it does not represent body memory following the death of a loved one. Hentz (2002) discovered in her interviews the past but rather reenacts it in the present through the body. Many researchers argue that that the body experience around the anniversary of the death was relived as it had been memories are tied to sensory systems and that experiences start with senses (Caldwell, 2012; experienced at the time of the loss. In her second study, Hentz (2012) analyzed a case that Fuchs, 2012; Rothschild, 2000). The way that the brain constructs representations of a again expanded on the grief process and revealed that body memory can be a part of a situation and the movements that result from that situation depend on interactions between survivor’s grief experience. the brain and the rest of the body (Damasio, 1994). Furthermore, emotional memories are

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said to be stored subcortically, which Totton (2003) states is equivalent to being stored bodily, closer proximity to the death rather than later on (Parkes, 1998; Field & Friedrichs, 2004). The since this region of the brain is strongly connected with the body. positive memories, the ones that the bereaved most likely wants to hold on to, can even be very Some researchers propose that body memory is a long-term or life-long representation painful soon after the death. As a result, the therapist’s role is to help the person come to terms of sensations, perceptions, and actions that result from and form individual understanding with the death and process some of the pain of grief before embarking on extensive work with of internal and external worlds (Glenberg, 1997; Kruithoff, 2012). Keleman (1987) adds memories (Worden, 2009). Those who are not able to process their pain may avoid feelings or that muscular movement patterns can also be a source of memory. “We recall an actual past things that remind them of the deceased loved one, thus inhibiting any work with body memory muscle pattern together with its emotional associations. By re-experiencing those patterns and and continuing bonds. associations, we make internal images to represent the event” (p. 28). Implicit memory, when Before a therapist can make use of a client’s body memory in the formation of continuing referring to the whole individual and not one or more systems in the brain, is sometimes used bonds, the therapist must first ensure that the survivor’s experience of memories about the to refer to body memory (Caldwell, 2012; Fuchs, 2012; Jansen, 2012). Therefore, Summa, deceased is positive. This does not mean that all of the survivor’s memories are, or will be, pleasant. Koch, Fuchs, and Müller (2012) argue that body memory is “a form of lived experience, Relationships have both positive and negative aspects to them. The goal here is to help the person which is constantly reactualized and implicitly lived through by a bodily subject” (p. 425). process both the pleasant and unpleasant memories. This can allow bereaved individuals to hold THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

onto the memories they want as well as work through any pain that arises. By supporting the Continuing Bonds Through the Body griever in working through the pain, the therapist can help the individual find comfort in the The goal of continuing bonds is to create an internal connection with the loved deceased, since pleasant memories. the external relationship is no longer possible. This internal relationship must be established in the There are various ways in which a therapist can support a mourner through this initial part body. In addition, this new relationship that is formed with the deceased is based on memories. of the grief process. Body psychotherapists can guide the person to use the body as a way to work Because of the somatic aspect of the relationship and the use of memories to create it, body through pain. It is important to help survivors understand that their reactions do not always memory can support the creation of continuing bonds. A bereaved individual’s body memory need to hurt and can become something pleasant. Some interventions that may be useful at is a way to discover how the body remembers the person who died, as well as to experience this point in the grief process, as well as throughout, are ones that help the individual tolerate memories of the deceased in a new way. This process can also help mourners uncover aspects of painful emotions and self-regulate. For instance, the therapist can guide the person to follow the the memories that they were not aware of before because body memories are a culmination of breath while talking about the memories that elicit intense emotions. By moving through the sensations, emotions, and cognitions. emotional pain of something linked to the deceased, the bereaved person can then discuss positive Body memory is not simply a remembering of the past, it is a connection to the past from experiences that are tied to the memory. There is an ebb and flow to the grief process. Therefore, the present. Gendlin (2012) remarks that body memory should not be considered exclusively in some days may be more painful than others, even years after the death. Body psychotherapy can the past because “the past reshapes itself in the course of the body’s present performance” (p. 73) be used in work with bereaved individuals to help them learn how these waves of grief come and and allows people to create something new. As a result, a mourner can use their body to recover go and how they react to and work through them. memories of the deceased loved one and reshape the relationship that once existed. For instance, the former external relationship can be recreated into one that resides in the bereaved individual’s Application: Using the Body to Create Continuing Bonds body; survivors can change how they relate to the memories of the deceased, namely, from only

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL cognitively to both cognitively and somatically. The survivor can achieve this by linking objects The following are proposed body psychotherapy interventions for bereaved individuals JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL or phenomena in the present moment and/or becoming aware of how the body responds to who are in grief counseling and experiencing uncomplicated grief. Working with memories the memories of the person who died. This ability to reshape the past can allow the bereaved and supporting the formation of continuing bonds is only one part of grief counseling. individual to create an internal representation of the person who died, which is the foundation of These techniques can be used in one session or they can span several sessions. It depends continuing bonds. on the particular client and how that client moves through the memory of the deceased There are many ways in which one can use the body to encode, store, and retrieve memories of or if that client wishes to work on multiple memories or death losses. The work is client- the deceased loved one. Body memory is comprised of sensations, movements, postures, gestures, driven, which is to say the client has an active role in determining how these interventions thoughts, and images (Koch et al., 2012). By working with these components that are associated are used. Furthermore, some of the linking objects or phenomena in these exercises may with the person who has died, a survivor can retrieve more embodied, and therefore possibly more still bring up unpleasant reactions for the mourner. It is the individual’s choice to decide substantial, memories. The act of embodying those experiences is the closest a mourner can get whether to turn the negative charge associated with those objects or phenomena into a more to once again being with the person who died. The individual no longer has access to the physical pleasurable experience. Some negative experiences, however, cannot be changed into positive person who has died but can still have the physical experience of that loved one. People’s bodies ones. Nonetheless, by working through the pain that arises from these occurrences, as well as and body memories give them the opportunity to create new relationships with the deceased. working with the person’s body memory of the deceased, the client can reshape the experience In order for a body psychotherapist to help a mourner retrieve and successfully work with of the past and have the opportunity to discover what really gives the individual enjoyment. body memories of the deceased, some time needs to pass to allow the initial, intense pain of the Continuing with Worden’s (2009) concept of tasks, these interventions are intended to loss to lessen. Reminders of the loved one are often considerably more emotionally painful in be action-oriented in that they provide bereaved individuals with tools to facilitate their own

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creation of positive connections with the deceased through their bodies. Body psychotherapy can clients can use something that they ate or drank with the deceased in order to remember those support these tasks by providing techniques that allow clients to become more familiar with their times with them. bodies and internal experiences. Grief is a unique experience for everyone. By building a bereaved Touch. Sometimes a client was touched in a certain way by their loved one. If someone individual’s awareness through breath and techniques to help tune into their body, such as a body touches them in a similar manner, this can evoke memories of when the person who has died used scan, a body psychotherapist can potentially help that person discover what their grief looks like to touch them. Touch however is still a controversial topic in therapy sessions (Strozier, Krizek, & and how it shows up in their body. The following interventions are ways in which body memory Sale, 2003). Therefore, the therapist could encourage clients to have people they feel close with can inform continuing bonds for survivors. They are based on the author’s experiences working touch them in ways the deceased used to, such as hugs or back scratches. In addition, the feel or with people who have experienced the death of a loved one. touch of a particular linking object can be used. For example, a bereaved individual can feel a flannel shirt to access memories associated with their loved one who once wore it Senses Exercises that incorporate the five senses use the client’s body to help in remembering the Movement person who died. These sensory experiences can facilitate the creation of continuing bonds that Movement is another way for a survivor to use their body to connect to memories of the THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

are formed not only from memories, but through the mourner’s body as well. The different senses deceased. One way individuals can accomplish this is by doing an activity they used to do with can evoke various memories, emotions, and bodily sensations. With all of these techniques, the the loved one who died. This could include performing a dance the client did with the person who therapist can start by having the person settle into the body by using deep breathing or having the died or gardening as the individual used to do with the deceased. client notice how the body feels in the moment. Additionally, the therapist can support the client Authentic movement is another way in which a person can get in touch with memories of by facilitating a body scan during the exercises so that the client can learn more about how their the deceased. This technique is a form of free association in movement (Payne, 2006 as cited in body responds to the different sensory experiences. Konopatsch & Payne, 2012). During authentic movement, the client can trigger memories through Smell. A client can bring in something that has a smell that is tied to a memory of the certain movements, body postures, or gestures (Konopatsch & Payne, 2012). In other instances, deceased. An example of this is a woman who keeps bottles of a lotion she frequently used when the memory of the deceased can create the impulse to move. A mourner may move freely and then she and her husband dated. The woman would smell the lotion in order to evoke memories of her suddenly think of a time they were playing a board game with their mother before she died. The husband from that time. memory of the board game was generated from a certain posture the person had assumed. Another way to use scents to create continuing bonds is by tying a new scent with the memory. These ways of creating ties to the deceased are different than moving like the deceased moved. The therapist can have the client think about positive memories that are connected to a photo Researchers have found that people who imitate the deceased through movements or by taking or object, as well as how the body feels during the recall of that memory. The person then smells on their somatic symptoms are most likely experiencing complicated grief (Lindemann, 1944; an enjoyable scent, one that is not necessarily tied to the memory. Later on, the person can smell Worden, 2009). This can be explained as the bereaved individual over-identifying with the person that scent, and now can bring up those positive memories and body sensations. This intervention who died, which can result from an inability to accept or adapt to the loss. Due to the nature of the may be useful when a mourner is having difficulty reconfiguring negative reactions to memories therapeutic relationship, the therapist should rely on the griever to share examples of symptoms into more positive ones. or movements of the loved one in order to assess whether the bereaved individual is taking on the Sight. Bereaved individuals may have a memory of seeing something with the person who persona of the deceased.

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL died or have pictures with the deceased that can be used. A survivor who spent summers with JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL their grandpa at the shore has memories of sitting with him on the beach watching the sunrise Memories as dolphins swam in the ocean. The individual can bring in pictures of dolphins or sunrises over All of the above techniques have a bottom-up approach in that they use the body to produce the ocean to help in connecting with these memories of their grandpa. As the person talks about different memories of the loved one who has died. It can be just as important to start with the memories of the shore, the therapist can support them in noticing how their body remembers memories and explore the body sensations that arise. As mentioned before, this can be useful when those memories as well. first working with memories during the grief journey in that it can help a bereaved individual Sound. There are numerous ways in which sound can link a survivor to the loved one who process pain. By focusing on the body when accessing memories of the deceased, the client died. For instance, people often listen to music that reminds them of the deceased. The music may can create a richer experience of the memories, one filled with sensations and emotions, rather also elicit associations the client had not thought about before. Sometimes hearing a certain noise, than only thoughts. For instance, a person may have gone on numerous camping trips with the such as laughter, can make a mourner think of the person who died. Therefore, a client can use deceased person. When recalling these trips, the individual can think of the events that occurred sounds that are somehow linked to the loved one to connect to the memories that are associated as well as experience how the body remembers the events. with those sounds. Taste. Bereaved individuals may have certain tastes that are tied to memories of the deceased. Conclusion A person who often ate spaghetti with their spouse can use that taste to bring up memories of their loved one. Or someone who drank coffee in the mornings while their child ate breakfast Research has shown that grief is an individual process and that grieving is a natural can use that same brand of coffee to connect back to those mornings. These are examples of how response to loss (Hooyman & Kramer, 2006; Rando, 1984). The grieving process is a somatic

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experience (e.g., Kowalski & Bondmass, 2008; Lindemann, 1944; Rando, 1984) and as such, it Bacon. only seems natural to use a therapeutic approach that incorporates the body when working with Bonanno, G. (2004). Loss, trauma, and human resilience: Have we underestimated the bereaved individuals. Mourners store numerous memories within their bodies, many of which human capacity to thrive after extremely aversive events? American Psychologist, 59(1), are unconscious, that wait to be accessed and integrated in a way that helps in reconciling grief. 22-28. Body psychotherapy can thus be used to work with a person’s body memories to connect to the Caldwell, C. (1997). Getting in touch: The guide to new body-centered therapies. Wheaton, deceased. In doing this, the mourner’s relationship with their loved one can become anchored in IL: Theosophical Publishing House. their body, which can then facilitate the creation of an internal relationship or continuing bond. Caldwell, C. (2012). Sensation, movement, and emotion: Explicit procedures for implicit A therapist can support this process by using interventions that incorporate the sense experiences, memories. In S. Koch, T. Fuchs, M. Summa, & C. Müller (Eds.), Body memory, movements, and body sensations that are associated with memories of a deceased loved one. metaphor and movement (pp. 255-265). Philadelphia, PA: John Benjamins Publishing The proposed framework assumes that clients have some level of body awareness. More Company. work may need to be done in sessions to help the bereaved individual learn about their body Casey, E. (2000). Remembering: A phenomenological study (2nd ed.). Bloomington: and bodily sensations. Furthermore, some people may believe that their bodies are foreign Indiana University Press. THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS

and unsafe. The therapist must therefore assess whether or not body interventions are right Corr, C., Nabe, C., & Corr, D. (Eds.). (2009). Death and dying, life and living (6th ed.). for the client or at that time. It should also be noted again that this therapeutic approach is Belmont, CA: Cengage Learning. meant for those experiencing uncomplicated grief. There are many complex factors that can Damasio, A. (1994). Descartes’ error: Emotion, reason and the human brain. New York, NY: result in a person having complicated grief. As a result, these survivors may require different Penguin Books. or supplementary therapeutic interventions as compared to those presented in this framework. Damasio, A. (1999). The feeling of what happens: Body, emotion and the making of There are many ways in which the body can be integrated into grief counseling and grief consciousness. Orlando, FL: Harcourt, Inc. therapy. This article illustrates only one way to work with the body in grief counseling, using Dillenburger, K, & Keenan, M. (2005). Bereavement: A D.I.S.C. analysis. Behavior and body memories to create or enrich continuing bonds. More research is needed to understand Social Issues, 14(2), 92-112. how to work with the grief process somatically. One of the next steps could be to empirically European Association for Body Psychotherapy. (n.d.). About body psychotherapy. Retrieved study how people use their bodies to create continuing bonds, as well as their experiences of from http://www.eabp.org/about.php doing so. Future work incorporating thanatology and body psychotherapy could also include Field, N., & Friedrichs, M. (2004). Continuing bonds in coping with the death of a research on how to use body interventions to support those who are experiencing complicated husband. Death Studies, 28, 597-620. grief and are unable to move through it. No matter the direction of potential research, therapists Field, N., Gao, B., & Paderna, L. (2005). Continuing bonds in bereavement: An must view grievers as whole entities, comprised of body and mind, in order to better serve attachment theory based perspective. Death Studies, 29, 1-23. them. The body would need to be used explicitly in the process. Field, N., Nichols, C., Holen, A., & Horowitz, M. (1999). The relation of continuing attachment to adjustment in conjugal bereavement. Journal of Consulting and Clinical BIOGRAPHY Psychology, 67(2), 212. Dyana Reisen, MA, CT, received her master’s degree in somatic counseling psychology at Freud, S. (1957). Mourning and melancholia. In J. Strachey (Ed. and trans.), Standard

INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Naropa University in 2013 with a concentration in body psychotherapy. Dyana has over edition of the complete psychological works of Sigmund Freud (Vol. 14). London, England: JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL six years of experience in thanatology through research, volunteer work at hospices, and Hogarth Press. (Original work published 1917). facilitation of bereavement support groups and individual grief counseling. She recently Fuchs, T. (2012). The phenomenology of body memory. In S. Koch, T. Fuchs, M. Summa, received her Certification in Thanatology through the Association for Death Education & C. Müller (Eds.), Body memory, metaphor and movement (pp. 9-22). Philadelphia, PA: and Counseling. Dyana would like to thank Elizabeth Collier, retired grief counselor and John Benjamins Publishing Company. instructor at The College of New Jersey, for introducing her to the field of thanatology Gendlin, E. (2012). Comment on Thomas Fuchs: The time of the explicating process. In S. and continually supporting Dyana throughout the development of her career. Dyana would Koch, T. Fuchs, M. Summa, & C. Müller (Eds.), Body memory, metaphor and movement also like to thank Dr. Christine Caldwell, Dean of Graduate Education and founder of the (pp. 73-81). Philadelphia, PA: John Benjamins Publishing Company. Somatic Psychology program at Naropa, for teaching her about body psychotherapy and Glenberg, A. (1997). What memory is for. Behavioral and Brain Sciences, 20, 1-55. body memory, concepts that now inform Dyana’s work with bereaved individuals. Glick, I., Weiss, R., & Parkes, C. (1974). The first year of bereavement. Toronto, Canada: Email: [email protected] John Wiley and Sons, Inc. Heller, M. (2012). Body psychotherapy: History, concepts, and methods. New York, NY: W. W. REFERENCES Norton & Company, Inc. Barrett, C., & Schneweis, K. (1981). An empirical search for stages of widowhood. Omega: Hentz, P. (2002). The body remembers: Grieving and a circle of time. Qualitative Health Journal of Death and Dying, 11, 97-104. Research, 12(2), 161-172. Bauman, S. (2008). Essential topics for the helping professional. Boston, MA: Pearson: Allyn & Hentz, P. (2012). Exemplar: The body grieves. In P. Munhall (Ed.), Nursing research: A

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3-27). Washington, DC: Taylor & Francis. The Impact of Body Awareness on Subjective Wellbeing: Silverman, P. & Worden, W. (1993). Children’s reactions to death of a parent. In M. The Role of Mindfulness Stroebe, W. Stroebe, & R. O. Hansson (Eds.), Handbook of bereavement: Theory, research, 1 and intervention (pp. 300-316). New York: Cambridge University Press. Olga Brani, BA MSc , Kate Hefferon, PhD, Tim Lomas, PhD, Itai Ivtzan, PhD, Joan Painter, PhD, University of East London Silverman, S., & Silverman, P. (1979). Parent-child communication in widowed families. American Journal of Psychotherapy, 33, 428-441. Received 4 February 2013; accepted in November 2013 Spratt, M., & Denney, D. (1991). Immune variables, depression, and plasma cortisol over time in suddenly bereaved parents. Journal of Neuropsychiatry and Clinical Neuroscience, 3(3), 299-306. Abstract Stroebe, M., Gergen, M., Gergen, K., & Stroebe, W. (1992). Broken hearts or broken Positive psychology has been criticized for the lack of research on the role of the bonds: Love and death in historical perspective. American Psychologist, 47(10), 1205. body in wellbeing. As the research into the many variables that influence subjective Stroebe, M., Hansson, R., Stroebe, W., & Schut, H. (2001). Introduction: Concepts wellbeing (SWB) continues, the important role of body awareness (BA) on SWB THE ART AND SCIENCE OF SOMATIC PRAXIS THE ART AND SCIENCE OF SOMATIC PRAXIS and issues in contemporary research on bereavement. In M. Stroebe, R. Hansson, W. has been neglected. It was hypothesised that there would be a significant predictive Stroebe, & H. Schut (Eds.), Handbook of bereavement research: Consequences, coping, and relationship between BA and SWB, and moreover that this relationship would be care (2-27). Washington, DC: American Psychological Association. moderated by mindfulness. One hundred and nineteen participants from the general Stroebe, M., Schut, H., & Stroebe, W. (1998). Trauma and grief: A comparative analysis. In population completed relevant self-report scales through an online survey. BA had J. Harvey (Ed.), Perspectives on Loss: A Sourcebook (pp. 81-96). Washington, DC: Taylor a positive relationship with SWB, but this relationship was not moderated by & Francis. mindfulness. These findings have implications for positive psychology that reinforce Stroebe, W., Stroebe, M., & Domittner, G. (1988). Individual and situational differences in the argument for more body-based interventions and overall embodiment within recovery from bereavement: A risk group identified. Journal of Social Issues, 44(3), 143-158. the discipline. Strozier, A., Krizek, C., & Sale, K. (2003). Touch: Its use in psychotherapy. Journal of Social Work Practice, 17(1), 49-62. Keywords: body awareness, subjective wellbeing, mindfulness, positive psychology Summa, M., Koch, S., Fuchs, T., & Müller, C. (2012). Body memory: An integration. In S. Koch, T. Fuchs, M. Summa, & C. Müller (Eds.), Body memory, metaphor and movement (pp. International Body Psychotherapy Journal The Art and Science of Somatic Praxis 255-265). Philadelphia, PA: John Benjamins Publishing Company. Volume 13, Number 1, spring 2014 ISSN 2169-4745 Printing, ISSN 2168-1279 Online Totton, N. (2003). Body psychotherapy: An introduction. Philadelphia, PA: Open © Author and USABP/EABP. Reprints and permissions [email protected] University Press. Totton, N. (2005). New dimensions in body psychotherapy. New York, NY: Open University Press. Introduction van der Kolk, B. (1987). Psychological trauma. Arlington, VA: American Psychiatric Publishing, Inc. The Mind-Body Problem INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL Volkan, V. (1981.) Linking objects and linking phenomena: A study of the forms, symptoms, JOURNAL PSYCHOTHERAPY BODY INTERNATIONAL The nature of the connection between the physical body and the subjective psyche has metapsychology and therapy of complicated mourning. New York, NY: International been of great interest to the field of psychology for many years (Hefferon, 2013). Indeed, this Universities Press. ‘mind-body problem’ has occupied thinkers throughout the centuries, giving rise to a range Worden, J. (1982). Grief counseling and grief therapy: A handbook for the mental health of philosophical positions on the subject. For example, materialistic monism grants primacy practitioner. New York, NY: Springer Publishing Company. to the physical body while the subjective mind is regarded as an illusion or epiphenomenon. Worden, J. (1991). Grief counseling and grief therapy: A handbook for the mental health Conversely, transcendental monism (or idealism) gives ontological primacy to the mind practitioner (2nd ed.). New York, NY: Springer Publishing Company. while the material body is viewed as an aspect of mind (e.g., a mental construct). Finally, a Worden, J. (2009). Grief counseling and grief therapy: A handbook for the mental health number of perspectives acknowledge the reality of both material body and subjective mind, practitioner (4th ed.). New York, NY: Springer Publishing Company. with different positions on the nature of their interaction. For instance, in Chalmer’s (1995) Zisook, S., DeVaul, R., & Click, Jr. M. (1982). Measuring symptoms of grief and dual-aspect theory, the fundamental ‘reality’ underlying both mind and body is information; bereavement. American Journal of Psychiatry, 139,1590-1593. this information is then manifested both physically (as the body and brain) and experienced Zisook, S., & Shear, M. (2009). Grief and bereavement: What psychiatrists need to know. subjectively (as the mind). World Psychiatry, 8(2), 67-74. Amidst debates around the mind-body problem, further confusion is generated by the Zisook, S., Shuchter, S., Irwin, M., Darko, D., Sledge, P., & Resovsky, K. (1994). ambiguous semantics of the word ‘body’. In the philosophical positions above, ‘body’ refers Bereavement, depression, and immune function. Psychiatry Research, 52(1), 1-10. to the physiological organism — which includes the brain — in contrast with the subjective mind. However, subjectivity also includes the felt experience of our own bodies, a construct i Corresponding author: [email protected] 94 95 96 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS this emergent focus on thebody in positive psychology, with body awareness being a perspectives onthe role ofthebodyonwellbeing andflourishing. Thispapercontinues explored anthropological, sociological,neurological, biological,andphenomenological 2011, p.176). More recently, bringingtogetherdiverse disciplines,Hefferon (2013)has sexual behavior, physicalactivity, nutrition,andeven physicalpain” (Hefferon & Boniwell, (Hefferon &Boniwell, 2011). These five componentsinclude:“humantouch, positive body’ hasbeenproposed, featuring five componentsthought topromote SWBandPWB Recent have beenmadetoredress efforts thislacuna. For instance,theconceptofa‘positive with thebodyanditsrelevance towellbeing (Hefferon &Boniwell, 2011;Hefferon, 2013). flourishing inlife. —isusedwithinpositive psychology toreferfrom theGreek to termmeaning‘true self’ (PWB), whichisalsoreferred toas‘eudaimonic wellbeing’ (Ryff, 1989).Eudaimonia — in lifehave beenrecognized andincorporatedwithintheideaofpsychological wellbeing for otherdimensionsofwellbeing. For ofpurpose andmeaning example,theimportance SWB tendtobelessprejudiced, more andshow trusting, higherlevels ofcooperation. but alsoonsocietiesasawhole(Tov &Diener, 2008).For example,individualswithhigh & Harris, 2003).Fourth, notonlydoesSWBhave apositive impactonanindividuallevel, with greater healthandindeedlongevity(Roysamb, Tambs, Reichborn-Kjennerud, Neale, (Diener, Nickerson, Lucas, &Sandvik, 2002). Third, SWBhasbeencausallyassociated Second, SWBislinkedtogreater work enjoyment andhigherlevels ofremuneration consequences ofSWBinfourareas oflife.First, SWBiscorrelated withincreased sociality. other positive outcomes.Lyubomirsky, King,andDiener (2005)have identifiedbeneficial have good, thatis,associatedwith alsoinvestigated theextenttowhichitisaninstrumental speaking, SWBreflects how peoplethinkandfeelabouttheirlives (Ozmete, 2011). tothebalanceor“ratio”component pertains ofpositive andnegative affect. Thus, broadly Smith, 1999). The cognitive componentrefers tosatisfactionwithlife. The affective viewed ascomprising acognitive andanaffective component(Diener, Suh, Lucas, & andexploredarticulated inpositive psychology is‘subjective wellbeing’ (SWB).SWBis of happinessandwellbeing (Seligman &Csikszentmihalyi, 2000).Amongtheconcepts seen theemergenceof‘positive psychology’, atermunitingscholarsinterested inissues psychology) aswell asotherdisciplinesmore broadly (e.g.,economics).Recent years have Wellbeing andPositive Psychology to ourunderstandingofwellbeing. relevance ofthebodyisunder-researched andunder-theorised.One suchdeficiencypertains correlates ofconsciousness’ paradigm(Fell, 2004).However, inmanyareas ofpsychology, the concern inpsychology, ofthe‘neural inconsciousnessstudiesundertherubric particularly (e.g., thoughts).Examining themind-bodyconnectionhasbecomeaprominent pointof conscious experience (e.g., embodied sensations) and mental aspects of conscious experience (including thebrain)andsubjective mind;andtherelationship between somaticaspectsof and approaching themind-bodyquestion:relationship between thematerialbody referred to as ‘embodiment’ (Riva et al., 2003). Thus, there are two ways of conceptualizing - The notionofwellbeing isofinterest to manyareas ofpsychology (e.g.,health However, positive psychology hasreceived criticismfornothavingsufficientlyengaged In additiontotheconceptofSWB,related have beenproposed constructs toaccount SWB isviewedasasubstantive good,desirableonitsown terms.However, researchers overall physiologicaland psychological balance. positive impacton sleepandrest patterns,abilitytoovercome demandingsituations, and (2010) studiedpatientswith a rangeofpsychiatric disorders, reporting thatBBAT had a Martinez-de-Salazar-Arboleas, &Sanchez-Guerrero, 2011).Finally, Johnsen &Raheim improved symptomology (Catalan-Matamoros, Helvik-Skjaerven, Labajos-Manzanares, Furthermore, apilotstudywithpatientssufferingfrom eatingdisorders foundthatBBAT also reported greater Pedersen satisfactionwiththeir treatment (Leirvag, 2010). &Karterud, BBAT showed greater improvement thanthosegiven psychodynamic group therapy, and with femalepatientssevere personalitydisorder foundthatpatientswhoundertook Global Physiotherapy Muscle andselfreports). Similarly, Examination, observations, astudy and personaldevelopment through the “harmonizing” ofmovements (measured withthe BBAT withthispopulation,Skateboe etal.foundthatBBAT promoted psychological growth BA, anddisturbedemotionalawareness andpsychomotor functioning.Exploring theuseof disorders are ofbodyimage,limited associatedwithissuesaround BA,suchasdistortions populations. For example, Skateboe, Friis, Hope and Vaglum (1989)suggestthat personality amplification — a tendency to experience somatic qualia in an intense and often noxious way consequences (Cioffi, 1991). For example, high BA was associated with somatosensory disorder, where itwasbelieved thatover-attention tosymptomsorbodyreactions hadadverse sensation. In the early 1990s, BA was predominantly studied in relation to anxiety or panic Mehling etal.(2009)usefullyconceptualiseitasattentiontoandawareness ofinternalbody (Roxendal, 1985,p.10). Althoughthere are manydefinitionsofBA(Bekker etal.,2008), body, representing bodyconsciousness,managementanddeepenedexperience” AwarenessBody potentially usefularea notbeeninvestigated. thathashitherto 2 individual’s own movement massage, breathing regulation, presence inthesituation, andafocusontheexperienceof in Nordic countriessuchasSweden (Archer, 2005). The maincomponentsofBBAT are BBAT, are becomingincreasingly utilized intreating psychiatric disorders, particularly (Feldenkrais, 1977),andtheMensedieck system(Gard, 2005). These BAT therapies,especially BATs includeBasic BodyAwareness Therapy (BBAT; Gyllensten, 2001),Feldenkrais therapy to collectively asbodyawareness therapies(BAT), centered onincreasing BA(Gard, 2005). eating disorders andsubstanceabuse(Burns, 2006). physiological orpsychological trauma(Price & Thompson, 2007)andpeoplesufferingfrom intriguing studies exploring the impact of BA on symptomology in those recovering from compared topatientswhotriedsuppress theirpain(Burns, 2006). There have alsobeen on the‘sensory components’ oftheirphysicalpainexperienced reduced subjective pain example, studiesinvolving patientswithchronic backpainfoundthatpatientswhofocused have beneficialphysiologicalandpsychological consequences(Mehling etal.,2009). For this negative appraisalofBA,recent studiesindicatethatattendingtoinnersensationscan — leadingtohypochondriasis,anxiety, andsomatization(Cioffi,1991). However, opposing

Some similarto thetheoriesofmindfulnessand its practices,andthiswillbe ofthesecomponentsare very discussed later. The studiesabove indicatethatBATs canhave abeneficialimpactinclinical A numberofstudieshave shown theimpactofBATs inclinical onwellbeing, particularly The notionofbodyawareness (BA)isan“overall conceptforexperienceanduseofthe Findings onthebenefitsofBAhave ledtotheemergenceof various therapies, referred 2 (Johnsen &Raheim,2010). (Johnsen THE IMPACT OFBODY AWARENESS 97 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 98 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS is asameansof getting“closer” to theirbodies,withtheaimof enhancing wellbeing. et al.(2011)report thatonemotivation forpeoplein the West topracticemindfulness are indeveloping BA.Lastly, alsoofimportance andperhapsmostrelevantly, Mehling required inorder toachieve mindfulness(e.g.attention, non-judging,concentration) the conceptofBA.Similarly, intermsofthedevelopment ofmindfulnessandBA,skills encompasses awareness of innersensations(aswell asthoughts),which overlaps with close conceptualkinshipbetween thetwoconstructs. They arguethat mindfulness the parallelsbetween mindfulnessandBA.Mehling etal.(2009)have highlightedthe interestof particular inthecontextofpresent studyare explanationsfocusingon life. In termsofaccountingfor the beneficial impact of mindfulnesson wellbeing, promotes wellbeing by increasing the“moment tomoment” intensityofaperson’s behavioral regulation. Additionally, Brown andRyan (2003)holdthatmindfulness thoughts, suchasunhealthybehaviorsandhabits, thus playsarole inpromoting suggest thatmindfulnesshelpsindividualsdisengage from automaticactionsand review). There are various explanationsforthispositive impact.Ryan andDeci (2000) positive outcomeslike SWB (Ivtzan et al, 2011;seeMars & Abbey, 2010,for a recent terms ofthealleviationdistress andmentalhealthissuesaswell asthepromotion of by “curiosity, opennessandacceptance” (p.232). involves attitudinal orientation to experiences, characterized the adoption of a particular recognition ofmentalevents inthepresent moment” (p.232). The secondcomponent such that “it is maintained on immediate experience thereby allowing for increased a two-componentmodel: The firstcomponentconcernsself-regulation ofattention, theoretical modelsofmindfulness.For example,Bishop etal.(2004)have proposed Beyond more have alsobeenmadetoconstruct orientingdefinitions,efforts detailed moment, and nonjudgmentally to theunfoldingof experience moment by moment”. as “the awareness thatemergesthrough payingattentiononpurpose,inthepresent Zinn (2003,p.145) offersawidelycited“operational working definition” ofmindfulness debate inthefieldofpsychology Ivtzan, (Hart, inpress). &Hart, However, Jon Kabat- conceptualize, define,operationalize, andmeasure mindfulnessare asource ofmuch has significantlygrown inrecent years (Brown etal.,2007).Questions around how to Mindfulness shares conceptualkinshipwithBA,namely, mindfulness. to remedy. However, studieshave madeaconnectionbetween SWBanda concept that on thebodyinpositive psychology asnotedabove —adeficiencythecurrent studyseeks further. This linkbetween BAand SWB isas yet untested —reflecting thelack of focus they mightenjoy corresponding risesinSWB,thusmotivating themtoincrease BAstill linked toSWB.Assuch,asindividualscomeexperienceincrementally greater BA, — have totraininBA?Apossibleanswer from positive psychology isthatBAmaybe same periodofchildhoodaslanguageacquisition. issue arises.Andersonthusproposes thatBAtrainingshouldbeginearlyinlife,the when theyare inahealthystate,ratherthanwaiting untilaphysicalormentalhealth Anderson (2006)suggeststhat it may be easier for people to proactively develop BA populations, withpatientsalready sufferingfrom pain,illness,orstress. However, - Academic and clinical interest derived in mindfulness, froma construct Buddhism, What motivation would a person in good health — with no stress, pain or illness A largebodyofwork has consistently linkedmindfulnesstowellbeing, bothin also asignificantpredictive relationship between mindfulnessandSWB. mediated therelationship between BAand SWB. There were twomainhypotheses: (and ifso,whichhadthegreater impact).Second, whethermindfulness we observed of sub-questions.First, we investigated whethermindfulnessandBAbothpredicted SWB beenresearched.hitherto More specifically, we broke thisquestiondown intoanumber This study seekstoexamine the relationship that mightexistbetween these, asit has not seeking todevelop BAasaroute togreater SWB. totheas-yet untestedpossibility,This lastfindingpertains notedabove, ofpeople Ryan, 2003). It includes15 items (e.g. ‘Icouldbe experiencing some emotion and not focuses onattention onandawareness ofwhatishappeninginthe present (Brown & (Brown &Ryan, 2003). This assessesanindividual’s frequency ofmindfulstates, and in factorstructure (Shields etal.,1989). = .80),hasgoodtest-retest reliability (r=.80),andhasdiscriminantvalidity andstability questionnaire is reliable for men (alpha coefficient = .82) and women (alpha coefficient ofme. true ofmeto(7)very scale rangingfrom (1)notat alltrue a 7-pointLikert This (e.g. ‘Inoticedifferences inthewaymybodyreacts tovarious foods.’) whichare ratedon by respondents tonormal‘non-emotive’ bodyprocesses. The questionnaire has18items 1989). This is a self-report measurement tool that assesses the level of attentiongiven (Pavot &Diener, 1993). (with analphacoefficientof0.87,anda2-monthtest-retest stabilitycoefficientof0.82) to (7) strongly agree (Diener et al., 1985). The scale has strong reliability and stability are scale,rangingfromparticipants (1)strongly askedtorateona7-pointLikert disagree own chosencriteria(Diener &Pavot, 1993). The scalefeatures five statementsthat self-report tool that allows respondents to assess their lives asa whole according to their using theSatisfaction withLifeScale(Diener etal.,1985). This scaleisawell-validated the three variables ofinterest: SWB,BAandmindfulness. Firstly, SWBwasassessed Design Participants’ agesrangedfrom 18to69withameanageof32.3(SD=13.41). wasofGreekso consequentlythelargestpercentage ofparticipants nationality(67%). oftheonlinesurvey.also collectedatthestart The firstauthor’s nationalityisGreek, oforigin,andgender,language. Demographic variables, includingage,country were that individualshadtobeover 18years oldandhave agoodknowledge oftheEnglish purpose and procedure as well as alinkto the onlinesurvey. Inclusion criteriawere Participants were contacted with an email, which included a description of the research anonlinesurvey.undertook Participants were alladultsfrom thegeneralpopulation. Participants H2: The relationship between BAandSWBwillbemoderatedby mindfulness. H1: There willbeasignificantpredictive relationship between BAandSWB, Thus, we have anexusofthree interrelated mindfulness,BA,andSWB. constructs: Finally, mindfulnesswasmeasured by theMindful Awareness andAttention Scale Secondly, BAwasassessedusingtheBodyAwareness Questionnaire (Shields etal., Data were gathered featuringthree through questionnaires anonlinesurvey measuring The research sampleconsistedof119males(42.9%)andfemales(57.1%)who Methods THE IMPACT OFBODY AWARENESS 99 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 100 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS relationship between BAandSWBisnotmoderatedthrough mindfulness. variables were centered priortotheanalysis). The results, shown in Table 2,indicatethatthe followed by mindfulnessandthentheinteractionterm(itmustbe noted thatthepredictor mediator, andSWBasthe dependentvariable. BA was entered intotheanalysisfirst, Hypothesis 2 14% ofthevariance inSWB, against3%forBA. mindfulness and SWB. However, mindfulness had greater predictive power, accountingfor variables andSWBastheDV. multiple regression are detailedin Table 1below. mindfulness were thepredictor variables, andSWBwastheDV. The results ofthestandard or between mindfulnessandSWB,amultipleregression analysiswasconducted.BAand Hypothesis 1 approval from theethicscommittee oftheUniversity ofEastLondon. data collectedwere stored inapassword-protected computer. This studyreceived ethical should any questions orproblems occur. Anonymityandconfidentiality were protected, and debriefed aboutthepurposeofstudyandgiven thecontactdetailsofresearchers were participants fullysign aninformedconsentform.Aftercompletionofthesurveys, wereparticipants informedoftheprocedure through aninformationsheetandaskedto wereparticipants Prior contactedby emailtoinvitethemparticipate. tothestudy, the guidelinesofUniversity ofEastLondon(UEL)CodeGood Practice. Initially, Psychology Society (BPS)CodeofEthics andConductaswell asinaccordance with Procedure has atest-retest reliability of.81(Brown &Ryan, 2003). (1) almostalwaysto(6)never. The scalehasbeenvalidated fordiverse groups and be consciousofituntilsometimelater.’), scalerangingfrom ratedona6-pointLikert - This studywasdesignedandconductedaccording totheguidelinesofBritish A moderationanalysiswasconductedwithBAasthemain effect, mindfulness asthe A significant predictive between BA andSWB, and betweenrelationship wasobserved R Squared=.182, Adj. RSquared=.167 Table 1. In order toexaminewhetherthere wasapredictive relationship between BAandSWB, Mindfulness BA Standard Multiple Regression results andMindfulness forBA asthepredictor .212 .087 B Analysis andResults .049 .041 Std.Error .374 .184 Beta .000 .034 Sig. Studies totrainand develop mindfulness, like Mindfulness-Based indicatethatinterventions adds to the ever-increasing body of work linking mindfulness to various outcomes of wellbeing. one inducementwouldbeexperiencing increments inSWBasaresult ofimproving BA. Anderson’s questionofwhatmight motivate healthyindividualstoundergoBAT training: children, thusengendering BAfrom ayoung age.Moreover, thesefinding are oneanswer to (2006) suggests,itmaybedesirable tofactorBAtrainingintotheearly-years educationof be usedwith“healthy” populationsasaway ofpromoting SWB.Indeed, asAnderson SWB inanonclinicalpopulation. The implicationhere isthatBAT hasthepotentialto &Raheim,2010).However,(Johnsen thepresent studyindicatesalinkbetween BAand potential to reduce mental health issues and improve symptomology in clinical populations aform ofBAT.who hadundertaken These previous studies have shown thatBAT hasthe targeted sampleofphysiologicallyorpsychologically orwithpeople unhealthyparticipants, our knowledge, alltheresearch studiesinthecurrent literature have beenconductedona for many reasons. First were of all, participants drawn from the general population. To bothhave theirownsimilar constructs, contributionstomakevis-à-visindividualwellbeing. by mindfulness.Again,thistendstoindicatethat BAandmindfulness,whileconceptually last point,we were thattheimpactofBAonSWBwasnotmoderated surprisedtoobserve not interchangeable, butcaninfluenceSWBin different ways. Secondly, corroborating this mindfulness onSWB(14%)exceeded thatofBA(3%).Evidently, are thesetwoconstructs Abbey, 2010).However, itwasstrikingtoseetheextentwhichpredictive power of connection has betweenbeen well-established these constructs in the literature (Mars & relationship between mindfulnessandSWB. This tooconfirmedourhypothesis,sincethe an explicitstatisticallinkbetween thesetwoconstructs. There wasalsoastrong predictive and SWB. While thiswasinlinewithour hypothesis,thisisthefirststudytoconfirm challenged ourexpectations.Firstly, apredictive we observed relationship between BA A predictive between relationship mindfulnessandSWB. wasalsoobserved This finding The predicted findingthatBAhasapositive predictive relationship withSWBisnotable The dataanalysisproduced asetofintriguingfindingsthatbothconfirmedandalso Step 3:RSquare=.189, Adj. RSquare=.167 Step 2:RSquare=.182, Adj. RSquare=.167 Step 1:RSquare= .043,Adj. RSquare=.034 Table 2. bax mind Step3 ba mind Step2 ba Step1 ba mind Results oftheModeration Analysis between andMindfulness BA .003 - .219 .103 .212 .087 .098 B Discussion .334 .049 .044 .049 .041 .044 Std.Error THE IMPACT OFBODY AWARENESS -.091 .387 .218 .374 .184 .207 Beta

.334 .000 .021 .000 .034 .027 Sig. 101 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 102 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS gathering techniques inthepresent study. Using makesithard anonline survey tocontrol the semanticinterpretations ofeachitem. There are limitationsaround the data- further by eachrespondent’s level ofknowledge andpracticeofmindfulness, variations in individual are reflective ofactualbehavior. issuesinclude Further response biasesinfluenced Grossmanthe construct. (2011)querieswhethertheself-reported mindfulness“skills” ofan lack contentvalidity andoverlook externalreferents thatwould determinethevalidity of and Awareness Scale,have beenraisedby Grossman (2011). It isarguedthat suchscales on self-report scalesassessing‘trait’ levels ofmindfulness,suchastheMindful Attention concept orpracticeofmindfulness,the ofBATs. Issues around relying werelimitation isthatparticipants notscreened forprevious knowledge orexperiencewiththe interpretations ofthefindings,andshow theneedforfuture research inthisarea. One key positive psychology more generally, asnotedabove. in termsofengagingmore withthebody. Indeed, thislastcommentcouldequallyapplyto then, itappearsthatmindfulnesspracticesmaybeabletolearn from BApractices,likeBAT, cognitions ratherthansomaticqualia(Teasdale, Segal, & Williams, 2003).In thissense body (Ditto, Eclache, &Goldman, 2006),mindfulnesspracticesarguablyfocusmore on of mindfulness.Indeed, whilesomeadaptationsofmindfulnessdofocusspecificallyonthe by mindfulness, indicating that BA does not completely overlap or fall within the concept However, itisalsonotablethatinourstudyBAoffered predictive power notaccountedfor rolestance maywell inSWB,thusgivingmindfulness “the itselfplayacrucial edge” over BA. emphasis on internalawareness, attitudinal stance. only mindfulness implies a particular This and compassion(Shapiro etal.,2006). While mindfulnessandBAbothshare acommon of subjective qualia,butimbuingthisawareness qualitiessuchaskindness withparticular holds thattheefficacyofmindfulnessdoesnot reside inpeoplesimplybecomingmore aware of mindfulness can perhaps be found in Bishop et al.’s (2004) two-component model. This and BAare distinct,albeitrelated, concepts.One explanationforthegreater predictive power that mindfulnesswasnotameditatingfactorintheBA-SWBlink,show thatmindfulness independent predictive powers of mindfulnessandBA,theregression analysisindicating directly implicatingmindfulnessasakeyprocess withinthedevelopment ofBA.However, the suggest thatmanypeoplewhopracticemindfulnessuseitasameanstodevelop BA,thus directly by the concept of mindfulness (Mehling et al., 2011). Indeed, Mehling et al. (2009) BA, such as somaticawareness andattention-focusing techniques, were perhaps captured more mindfulness. This prediction wasinformedby literature that indicated that many aspects of analysis, namelytheprediction that thelinkbetween BAandSWBwouldbemoderatedby wellbeing andthatconceptuallyonecannotbereduced toorsubsumedwithintheother. mindfulness. This indicatesthat both mindfulness and BA make unique contributions to discriminantpredictiveBA constitutesafurther power over andabove the14%given by the interrelationship of mindfulness, BA, and SWB. The 3%predictive power offered by tocorroborate theseprevioussimply serves studies,theuniqueangleoffered here concerns of SWB(Carlson&Brown, findinginthecurrent 2005).Althoughthisparticular study used inthepresent study(Brown &Ryan, 2003)—hasbeenlinked withhigherlevels as a personality characteristic, indexed by the Mindful Awareness and Attention Scale so-called ‘trait’ mindfulness—relatively stablelevels ofmindfulawareness conceptualized Stress toelevate Reduction, levels ofSWB(Carmody&Baer, canserve 2008).Moreover, - This latter point is also supported by therejectionThis latterpointisalsosupported ofthesecondhypothesisin However, thelimitationsofstudymeanthatcautionshould beexercised withthese in termsofprevious lightonwhethermindfulness mindfulnessexperience,toshedfurther Responding tothefirstlimitationraisedabove, future studieswillideallyscreen participants research hasindicatedthatthere maybecomplexlinksbetween mindfulness, BA,andSWB. al., 2003). towards thosefrom thehigherendsofsocioeconomicandeducationalspectra(Riva et less access to or familiarity with the Internet, the sample such as older populations) and skew is that it may exclude sections (i.e, of those the populationwithfrom particular participating measurement tools correctly (Riva et al., 2003). Another limitation to online data collection even Internet connectivity. Thus, itcannot beassured thatallreceived theinformationand mayhave environment: different participants software, equipment,andthe participatory physical activity, andembodiment. internationally. Her research interests includewellbeing, post-traumaticgrowth, resilience, reviewed papers,books,andbookchapters haspresented atconferences nationallyand and seniorlecturer atthe University ofEastLondon. She istheauthor ofseveral peer- aging, and embodiment. Dr. Kate Hefferon, PhD, isachartered research psychologist experience mostly focusesonadolescentsandher research interests include wellbeing, positive Olga Brani holdsaBAinpsychology andanMScinappliedpositive psychology. Her clinical BIOGRAPHIES connections amongthesethree constructs. SWB insubtlydifferent ways.Future research teaseoutthesubtle willbeabletofurther indicates thatBAandmindfulnessare butthateachimpactupon notisomorphicconstructs, that mindfulnesswasnotfoundtomediatetherelationship between BAandSWB. This notable thatBAstillhadanimpactindependentofmindfulness. Similarly, itwasstriking to theBA-SWBrelationship, mindfulnesshadgreater predictive power. However, it was addition, apredictive relationship was found between mindfulnessandSWB.Compared population couldbetrainedtoincrease lineofinquiry. levels ofBAwouldbeafruitful In route toincreased SWB.Further research onwhetherhealthyindividualsfrom thegeneral as itsuggeststhatindividualscouldbenefitfrom becomingmore bodilyaware asapotential revealed inthecurrent study. BA andSWB.Such cross-cultural research willhelp torefine anddevelop theconnections developed), whichmay alter the wayin which their experienceof mindfulness intersects with understanding ofmindfulness(i.e.,awareness of the broader religious contextin which itwas However, peoplefrom Asiancultures may have a more contextualized appreciation and to begenerallydecontextualized from itsantecedentBuddhist origins(Kabat-Zinn, 2003). with peoplefrom different culturalbackgrounds. Mindfulness aspresented inthe West tends In addition,itwouldbeinteresting toexplore theintersectionsofmindfulness,BA,andSWB from harder-to-reach populationsaswell astoexplore alternative methodsofdatacollection. directions the sampleinparticular meansgreater shouldbemadetorecruitskewing efforts plays amoderatingrole between BAandSWB.Issues around onlinedatacollectionmethods Recognition research. oftheselimitationsilluminatesthewayaheadforfurther The current The studyfoundapredictive relationship between BAandSWB. This findingis valuable Conclusion THE IMPACT OFBODY AWARENESS 103 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 104 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Brown, K.W., Ryan, R.M.,Creswell, J.D. (2007). Mindfulness: Theoretical foundationsand Brown, K.W., Ryan, R.M.(2003). The benefitsofbeingpresent: Mindfulness andits role on Abbey, S.,Speca, M., Velting, D.,&Devins, G.(2004).Mindfulness: Aproposed operational Bishop, R.S.,Lau,M.,Shapiro, S.,Carlson,L.,Anderson, D.N.,Carmody, J.,Segal, V.Z., Bekker, M.H.,Croon, M.A.,van Balkom, E.G.& Vermee, J.B.(2008).Predicting individual Archer, S.(2005)Bodyawareness therapiesemerging. Anderson, R.(2006).Bodyintelligencescale:Defining andmeasuringtheintelligenceof REFERENCES due forpublicationby Sage inSeptember 2014. a positive psychology textbook,entitled Health, models ofwellbeing. 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105 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 106 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Lyubomirsky, S.,King,L.,&Diener, E.(2005). The benefitsoffrequent positive affect: H.,Pedersen,Leirvag, S.(2010).Long-termcontinuationtreatment G.,&Karterud, - Shields, A.S.,Mallory, E.M.&Simon, A.(1989). The bodyawareness questionnaire: Shapiro, G.E.,Astin,J.A&Freedman, L.S.,Schwartz, B.(2006), Seligman, M.E.P., &Csikszentmihalyi, M.(2000).Positive psychology: Anintroduction. Ryff, orisit?Explorations onthemeaningof C.D.(1989).Happiness iseverything, Ryan, andthefacilitationofintrinsic R.M.&Deci, E.L.(2000).Self determinationtheory Roysamb, E., Tambs, K.,Reichborn-Kjennerud, E.,Neale, M.C.,&Harris, J.R.(2003). Roxendale, G.(1985).Bodyawareness therapyandthebodyawareness scale.Goteborgs Riva, G., Teruzzi, T. &Anolli,L.(2003). The useoftheinternetinpsychological research: Radloff, L.S.(1977). The CES-Dscale:Aselfreport depression scaleforresearch inthegeneral Price, J.C,& Thompson, E.A.(2007).Measuring dimensionsofbodyconnection:Body Pavot, W. &Diener, E.(1993).Review ofthesatisfactionwithlifescale. Pallant, J.(2007). Ozmete, E.(2011).Subjective wellbeing: Aresearch onlifesatisfactionascognitive component Naughton, M.J.& Wiklund, I.(1993).Acritical review ofdimension-specificmeasures of Mehling, W.E., Wrubel, J.,Dauvenmier, J.J.,Price, J.C., Kerr, E.C.,Silow, T., Gopisetty, V. Mehling, W.E., Gopisetty, V., Daubenmier, J.,Price, C.J.,Hecht, F.M., &Stewart, A.(2009). Mars, T. S.,&Abbey, H.(2010).Mindfulness meditationpractiseasahealthcare intervention: Does happinessleadtosuccess? costs ofdistinguishingbetween hedonicsandeudemonia. Reliability andvalidity. Psychology. American Psychologist, 55, 5-14. psychological well-being. motivation, socialdevelopment andwellbeing. and SocialPsychology, between subjective wellbeing, perceived health,andsomaticillness. Happiness andhealth:Environmental andgeneticcontributionstotherelationships Universitet, (Thesis). Comparison of online and offline questionnaires. population. 13(9), 945-953. awareness andbodilydissociation. 5(2), 164-172. of subjective wellbeing. health related qualityoflifeincross-cultural research. Quality ofLifeResearch, 2,397-432. ground ofmind-bodytherapies. & Stewart, intothecommon L.A.(2011).Bodyawareness: Aphenomenologicalinquiry journal.pone.0005614. Body awareness: andselfreport measures. Construct A systematicreview. Psychiatry, Body awareness group therapyversus psychodynamic group therapy. daytreatmentafter short-term offemalepatientswithsevere personalitydisorders: Psychology, 64,115-122. New York: Oxford University Press. 3(4), 219-233. Applied Psychological Measurement, SPSS Survival manual International Journal ofOsteopathicMedicine 5,1136-1146. International Journal ofAcademic Research, Journal of Personality Assessment, Journal ofPersonality andSocialPsychology, Philosophy andHumanities in Medicine, Psychological Bulletin, The Journal Medicine, ofAlternative andComplementary . McGraw Hill: Open University Press. 1(3), 385-401. 1(3), 385-401. American Psychologist, Cyber and Behavior, Psychology PLos One 131,803-855. 53(4),802-815. The Journal ofPositive 4(5): e5614.doi:10.1371/ 13(2), 56-66. 3(4),55-61. Meditation andPositive Psychological Assessment, Journal ofPersonality 57(6),1069-1081. 55,68-78. Nordic Journal of 6(6), 1-12. 6(6), 1-12. 6(1), 72-80.

Tov, W., &Diener, E.(2008). The wellbeing ofnations:Linkingtogethertrust, Teasdale, J.D.,Segal, S. V., & Williams, J.M.G.(2003).Mindfulness trainingand Skatteboe, U.B.,Friis, S.,Hope, M.K., Vaglum, P. (1989).Bodyawareness group therapy Malden, MA:Blackwell Publishing. Cooperation: cooperation anddemocracy. In B.A.Sullivan, M.Snyder, &J.L.Sullivan (Eds), problem formulation. Psychotherapy andPsychosomatics, for patientswithpersonalitydisorders. 1.Description ofthetherapeuticmethod. The political psychology ofeffective humaninteraction The politicalpsychology Clinical Psychology: ScienceandPractice,Clinical Psychology: 51(1),11-17. H IPC O BD AWARENESS BODY OF IMPACT THE 10(2),157-160. (pp. 323-343),

107 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 108 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS that afunctional unityexistsbetween mindandbody” (United States AssociationforBody interactions between thebodyand themind,withcommon underlying assumptionbeing of mind-body functioning that takes into account the complexity of the intersections of and into themessagesofgutbrain. awareness andunderstanding ofselfifonlycommunicatingwiththeheadbrainandnot tapping it contains. Therapists may missvitalinformationwithinasessionthatcouldfacilitate aclient’s system generates acopious amount ofinformation from themillions of neuronsenteric nervous its walls,which,from esophagustoanus,measures aboutninemeters(Gershon, 1998). The 100 millionneurons (more thaneitherthespinalcord system)within orperipheralnervous ENS consistsoftheesophagus,stomach,smallintestines,and largeintestines,andcontains stated that the ENSis“the of the gastrointestinal tract” intrinsic innervation (p. 227). The the abilitytothinkforitself(Boyesen, 2001;Gershon, 1998; Mayer, 2011).Gershon (1981) systeminourviscera,isasecond brainwithinthebodyandhas that theENS,nervous system (ENS). Severalbrain in thegut is called the enteric nervous researchers have proposed individual actually carries two brains within the body: one in the head and one in the gut. The © Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 13,Number 1,spring2014 International BodyPsychotherapy Journal STEPHANIE POLLOCK, MA and responding to the gut in the moment. and responding tothegutinmoment. of thegut’s messages inorder toincrease emotionalself-regulation by appropriately listening presented tofosterconsciousnessoftheENS.ENSawareness isintendedtoinformaperson person’s eating, needing, andsensing is digested in the gut brain. Examples and questions are peristalsis, andtheoriesofthebody. This E.N.S.systemincludespaying attentiontohow a is proposed forhow tocultivate awareness oftheENS,utilizingscientific research, psycho- system (ENS), thebrainingut,intobodypsychotherapy enteric nervous (BP). A system with clientsinasessionaswell asacross time. This systemproposes theinclusionof The Eating,Needing, Sensing (E.N.S.)systemisasomaticinsight-basedtherapyforworking counseling Body psychotherapy (BP)isadistinctbranchofpsychotherapy involving an“explicit theory Most people believe that intelligencecomes from the brain in our heads. However, each Keywords: The Enteric System Nervous andBodyPsychotherapy: Cultivating a Relationship withtheGut Brain bodypsychotherapy, system,secondbrain,gutnutritional entericnervous Received 15April 2013;acceptedinDecember 2013 ISSN 2169-4745Printing, ISSN2168-1279Online Stephanie Pollock, MA The Art andScienceofSomaticPraxis Introduction Abstract enteric nervous system. enteric nervous The BodyingPractice (Keleman, 2004),Psycho-Peristalsis (Boyesen, Needing, Sensing system, E.N.S. willbeused, while ENSwithout periods will refer to the systems. to helpclientsbecomeaware oftheirentericnervous acronym E.N.S., where E stands for Eating, N stands for Needing, and S stands for Sensing, ENS within each client, inspired by body psychotherapy interventions. This system uses the clinical practice. explores bodypsychotherapists theuniquewayinwhichattentiontoENS cansupport in system(CNS)(Gershon, 1998). to operateseparatelyfrom thecentralnervous This paper Yet, system, which have been found BP has not historically attended to the gut and its nervous Psychotherapy, forclientwell-being. 2013).BPclaims thatlisteningtothebodyisimportant i colonies ofbacteria,thusmaintaining optimalhealth(Peristalsis, 2013). propelling andfunctions asacleansingtoolthatremoves foodforward, potentially harmful to theheadbrain(Gershon, 1998;Baker, 2005).Peristalsis helpswithabsorptionoffoodand Additionally, serotonin aidsinsignalingperistalticaction andcommunicationfrom thegut to depression, migraines,and other neuropsychiatric illnesses (Kim & Camilleri, 2000). seven different serotonin receptors (Gershon, 1998).Serotonin isaneurotransmitter relevant (GI) tract,consistingofthestomachandintestines(Kim&Camilleri, 2000). The guthasover 1998; Mayer, 2011).It isestimatedthat95%ofserotonin islocatedwithinthegastrointestinal “neuroses” ofitsown andexperienceaninabilitytoprocess inputfrom theheadbrain(Gershon, found tooperateseparatelyfrom theheadbrain, making itpossiblethattheENScouldhave acetylcholine, maketheENSfunctionmuchlikebrainin thehead. The gutbrainhasbeen thatamultitudeofneurotransmitters in thegut,suchasserotonin(1998) asserted and prominent research inthefield. in thehead.In order tounderstandthevalue and functionoftheENS,we turntosome interchangeably system,and“headbrain” torefer totheentericnervous willrefer tothebrain procedure (Heuristic, n.d.). Additionally, “ENS”, “gut brain”, and “second brain” will be used and facilitateproper digestionoffood.“System” isdefinedasanorganized orestablished messages, theycanusethetoolsinE.N.S.systemasameanstorelease repressed emotion be repressed, ignored, ordrowned outby the headbrain.Asclientsbecomeaware ofgut (Gershon, 1998).Still,communication viathevagus nerve messagesfrom thegutbrainmight its messageswillnotbediscountedinthispaper. The brainandthegutare inconstant moment-to-moment bodyattentiveness. monitoring responses toemotions)through internal listeningtoone’s uniquebodilyneeds;and brain processes eating, needing, and sensing; increase emotional self-regulation (managing and system. The goals ofworking withtheE.N.S.systemare to:cultivate awareness ofhow thegut thatwillbeusedinconjunctionwiththeEating,Needing,BP interventions Sensing (E.N.S.) 1974), theFocusing Technique (Cornell, 1996),andtheuseofbreath forrelaxation are the

The authordevisedthissystemworking withclientsaswell asherown bodyfrom 2006to2013.She learnedthat Nutrition, the Institute for the Psychology of Eating, her yoga teacher trainings, and studies in body psychotherapy. they related tootheraspectsof life. The authoradaptedandintegrated materialfrom theInstitute forIntegrative psychology andbodypsychotherapy illuminatedtherelationship between how clientsapproached foodandhow what wasrelevant wasnotjustwhatherclientswere eatingbuthow, when,andwhytheywere eating food.Eating The theory proposed here isasysteminwhichtherapistscanfacilitateawarenessThe theory ofthe The ENSwasfirstpopularized asasecondbrain by Michael Gershon (1998). Gershon It tonotethattheCNS(whichincludesbrainandspinalcord) isimportant and Literature Review THE ENTERICNERVOUS SYSTEM 1 When speakingoftheEating, 109 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 110 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS detrimental to mental health as issues within other nervous systemsinthebody.detrimental tomentalhealth asissueswithinothernervous systemandthatachangeinthe ENScanbejustascan functionasaseparatenervous 2005; Sykes et al., 2003). It system that the enteric nervous is not a common view andalterationsintheheadbrain(Drossman,linked IBSwithdisruptions 2005;Mertz, the ENShascognitive capabilitiessimilartotheCNS.Numerous researchers have 1999; Mertz, 2005;Scaer, 2013). It isdifficult tofindanyresearch indicatingthat in theGItractcorrelate withneurological andpsychiatric features (McMillin etal., Stam etal.,1997). The ideathatalterationsinthegutprecede IBS isonlyoneview. to alterthegut’s capacitytofunction(Gui, 1998;Mayer, 2000;Mayer etal.,2001; al., 2011).Many researchers have foundthatIBSisconnectedto stress and its ability including painintheabdomen,gas,bloating,constipation, ordiarrhea(O’Mahoney et that affectitsfunctioningcorrelate withtheonsetofIrritable Bowel Syndrome (IBS), &O’Mahony,2012; Cryan 2011;O’Mahony etal.,2011). The alterationsinthegut behavior, painperception, andhow thestress systemresponds inadulthood(Carpenter, 2011). to have otherbeneficialpsychological effects(Carpenter, &O’Mahony, 2012; Cryan bacteria, hasshown itsabilitytoreduce anxiety, decrease production, and cortisol pain modulation,andchangegutflora.Research onprobiotics, atypeofbeneficial adrenal (HPA) axis(involved inthestress response) thatincrease hyperactivity, decrease that stress from maternalseparationcausesalterationsinthehypothalamic-pituitary Mayer, 2000;Mayer etal.,2001;Stam etal.,1997).O’Mahony etal.(2011)found the guthave beenfoundtoaltertheabilityofENSfunctionproperly (Gui, 1998; systems throughout thebodyincludingGItract. The effectsofstress andtraumaon food (Mayer, 2011). its firstvalue-based mapoftheworldbasedonpositive andnegative experienceswith experiences with food intake,satiation, and gut responses provide with the newborn ingestion) are held within the gut, affecting the homeostasis of the ENS. The infant’s andpleasurepain (hungerandabdominaldiscomfort) (related totheexperienceof Love &Sterling, 2011).Mayer (2011)theorizes thatanewborn’s firstexperienceof their parents, mayaffectthepersonalityanddevelopment oftheENS(Gershon, 1998; system (Love &Sterling, 2011).Earlyexperiences,suchasaninfant’s interactionswith al., 2002). The firstcompletelydeveloped systeminthebodyofafetusisitsdigestive Pham etal.,2004),whentheENSisplastic(adaptable)andstilldeveloping (Boyen, et cellswithintheENScontinuetobecreatedthat new post-natally (Gershon, 1998; ability oftheimmunesystemtofunction(Gershon, 1998). Tension inthegutbrainmayblockproduction ofendorphins,diminishingthe 1998). Endorphins playarole inthedefensive response tostress (Amiretal.,1980). endogenous opiates,are madeintheENSandinfluence theimmunesystem(Gershon, mental health(Leonard, 2007;Esch,2002).In addition,50%ofendorphins,whichare the gut.Some research hasfoundaconnection between ahealthyimmunesystemand STEPHANIE POLLOCK, MA The formationofahealthygutisinitiatedinthewomb. Various researchers posit Mayer (2011)claimsthat70-80%ofthebody’s immunecellsare inthetissuesof The opposite perspective has also been observed, demonstratinghowThe oppositeperspective has alsobeenobserved, disturbances Healthy gutfloraalsoinfluencesneuraldevelopment, brainchemistry, emotional O’Mahony thatearly-lifestress etal.(2011)assert induces alterationsinmany King (2011)foundsimilarresults intheirresearch calledborborygmi. onstomachrumblings, session at times of insight or after a moment of expression and resolution. Da Silva (1990) and gut (Boyesen, 1974). the bodythatprovides aconnectionbetween psyche andsoma istrackedviasoundsinthe named thedigestionoflifeexperience“psycho-peristalsis”, whichisthehealing mechanismin the body. She focusedhertherapeuticwork onthegutfor releasing undigestedemotions. She Boyesen (2001)believed thatthedigestive of tractisthemostprimitive andinstinctualpart claiming thatthegutstores emotionalenergytobereleased andintegrated(Boyesen, 1980). The Enteric Nervous System Psychotherapy andBody are created from processes intheheadbrain(Damasio, 1999;Scaer, 2013). Additionally, someresearch wouldarguethatemotions cannotbeheldinthedigestive tractand due tothefactthatreflections onpastgutsensationsare basedontheclient’s subjective memories. an individual (Love & Sterling, 2011). It that Love is noteworthy & Sterling’s data are speculative messages. Gut reflection isbelieved tothendislodgetheexternalthinkingthatcausesdistress to eventually sendsignals tooverwhelm thehead brainandmakeanindividuallistentothegut’s under duress. It istheorized thatwhen theENSstaysinastress response forlongenough itwill past inorder tointegratethoseexperiencesintothepresent (Love &Sterling, 2011). When feelingsoffullandemptywere firstfeltcanpotentiallybe revealed by explorationsofthe listen tointernalhungerandfullnesscuescanbeaffectedby theenvironment andexternalfactors. the headbrainaschildren are externallyinfluenced (Love & Sterling, 2011).Achild’s abilityto shaped by ENSinformation isdrowned theexternalworldwhichtheyrely ontosurvive; outby body. They speculatethatfrom anearlyage,children lose touch withtheir gut feelings and are of and an aversion to emptiness, and a striving for both physical and emotional fullness in the Love &Sterling, 2011).Love &Sterling there (2011)statethatfrom thetimeofbirth isawareness can helpanindividualconsciouslyrelease pastwoundsviatheENS(Da Silva, 1990;King,2011; guts (Boyesen, 2001). meant to bring awareness, integrate repressed energy, and empty suppressed content from the difficult toprocess food,emotionalenergy, andstress (Schaible,2009). Psycho-peristalsis is stiff andarmored, whichislikelyto causetissuechangesandlossofperistalsis,makingit and thusaffectthebody’s abilityto function(Schaible,2009).Internal organscanbecome massage is meant to break down habitual ways of being that shape muscle tone and posture, (2001) listenedtotheintestinesviaastethoscopeinBiodynamic Massage. This kindof relaxation allows theintestinestosettleanddigestion function(Boyesen, 2001).Boyesen becomes physicallyandemotionallyimpaired (Boyesen, 2001; Vianna etal.,2006).Physical likely tooccurwithintheENS. groaned. When oneisabletobeaware ofandexpress one’s gutmessages,relaxation ismost feel theiremotions. The clientthenverbalized theirperception ofwhythetherapist’s stomach In response tothetherapist’s stomachnoises,theclientbegantolistenhisown bodyand a loudgroan from hisstomachwhileaclientwastalkingofunresolved issues(King,2011). sessions. For example,atherapistspoke ofexperiencingasinkingsensationintheirgutand asawaytoprocess therapeutic content during The findingsdetailedtheuseofborborygmi Boyesen (1974)contendedthatsoundsfrom thegutcanbeheard inaBiodynamic Massage Body psychotherapist Gerda Boyesen created Biodynamic Psychology inthe1970’s, A person listening only to the head brain can ignore messages from the gut brain until it is Many researchers believe feelingsmaybeheldinthegutandthatreflection ongutsensations When one experiences negative emotions, the intestines naturally cramp and digestion THE ENTERICNERVOUS SYSTEM 111 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 112 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS input from thegut.Digestion typicallyinvolves strippingfoodof whatisneededanddisposing of to how theENSdigestsfood, sensations, andneedscouldfacilitatetheprocessing old of new therapy (Damasio, 1999;Schall,2004),butthethird underexplored elementisthegut.Attention head brain,andbehavior. Research thecorrelation supports between the headbrainandbehaviorin & Sterling (2011), andMayer (2001), there seems to be a strong relationship between the gut, feasible thatfoodchoicesaffecthow bodiesandactionsare shapedfrom theinsideout. of foodcanbeanexperienceone’s self(David, 1991).Asfoodis digested within theENS,itis the emotionalsufferingthatwascovered upby thosesubstitutes(David, 1991).One’s experience to quench emotional hunger can bring about painful physical manifestations of food and drugs, up withhavingfuninthesnowfood. Lettinggoofsubstitutes,suchas isbeingfilled by primary activity, career, andspiritual practice.Anindividualwhoforgetstoeatlunchfrom beingcaught food (thethatnourishesthebodyfirst)tobehow oneisfilled byone’s relationships,physical hunger tosatiateemotional(Locher, Yoels, Maurer, &Ells, 2005; Wardle, 1990). awareness oftheemotionalprocessing oftheENS,humanscanreach forwhatwouldfillaphysical et al.(2011)foundthatexperiencingtheemotionofsadnesswillincrease theurgetoeat. Without foodsdependingonaneedtoperpetuateorstopfeeling.Oudenhove individual maychoosecertain one’sproduces fewerenzymes,andinterrupts abilitytodigestfoodproperly (David, 1991).An thatwe eatwhatwesupport are. When eatingunderstress, onehaslesssaliva inthemouth,which way totapintotheseemotionsandsensationsintheENSisthrough thefoodoneisdigesting. person learningtositupwithanerect spineandthereby internalemotions.Another invoking new bodystructure (Keleman,organization ofanew 1975; Young, 2005). This couldbeassimplea 1975; Young, 2005).Disintegration ofcurrent bodyalignmentcanthenoccur, leadingtothere- thoughts andemotionsthatcorrelate withtheformationofone’s physicalstructure (Keleman, & Zimberoff, 2004; Keleman, 1975). Noticing posture and tension may allow one to tap into body (Caldwell, 1997;Keleman, 1975). Yet, experience,thebodyre-forms witheachnew (Hartman may affecttheformofbody. ENS, and in turn the proper functioningof the ENS, comprising moving, processing, anddigesting, fullness (David, 1991). Thus, theform of thebodyaffectsall muscles and organs,includingthe 1991). Alignmentofthespinemaybeaprecursor toexperiencingbiologicalandpsychological Slouching cancauseperistalticwaves tobeirregular andmayeven lockfoodinoneplace(David, example, posture whileeatingaffectshow theENSdigestsinput(David, 1991;Hirota etal.,2002). When there isanatomicalchange,there isbehavioralchangeandviceversa (Keleman, 2008).For this bodilyexperience,andthencollapsingtheintensificationto patternsofbeing. re-organize new the BodyingPractice, whichinvolves becomingaware ofhow oneislivinginone’s body, intensifying the shapeofanybodyisabehavior(Keleman, 2008).Keleman (2004)usesamethodologycalled of Formative Psychology, explainsthattheshapeabodytakesisananatomicalorganizationand tissue,muscle,organ,cell,thought,andfeeling.Stanleythe worldandaffectevery Keleman, creator The Enteric Nervous System andtheBody STEPHANIE POLLOCK, MA The body is constantly pulsating, but it can be interrupted, deadening satisfaction within the deadeningsatisfactionwithinthe The bodyisconstantlypulsating,butitcanbeinterrupted, Somatic patternslikeposture can,according toKeleman (2003),shapethewayoneexperiences As seenintheworks of Boyesen (2001),David (1991),Gershon (1998),Keleman (2008),Love Joshua Rosenthal (2008),founderoftheInstitute forIntegrative Nutrition, considersprimary Marc David (1991), founder of the Institute for the Psychology of Eating, and Gershon (1998) Theory life. Therefore, thedefinitionsofdigestionandnourishmentcanexpandtoincludehow thebody down. Nourishment can come from the food one puts into one’s body and how one is fed by one’s events, trauma,andlifeexperiencesare processed withinthegut,inadditiontohow foodisbroken (2011), andLove &Sterling (2011),show thatdigestioninthegutcanincludehow emotions, proper digestionoffood,andcurrent states.Explorations by Boyesen (2001),Da Silva (1990),King in thegut. ofinformationaboutemotions,pastexperiences, The gutbrainmaycontainallsorts affects thebody, discovering themeaningofcravingsandneeds,payingattentiontosensations what isnot. The individualcanthenrespond differently toENSmessagesthrough gutinsight. new with sensationsandneedsusetheinformationthatisusefulfrom theexplorationandrelease what isnot.Digestion ofsensationsandneedscanwork thesameway. Anindividualcanengage can cultivate a trusting relationship with the gut brain. relationshipcan cultivate atrusting withthegutbrain. and negatethebenefitsofeating whole,unprocessed foods.Eatingconsistentlythroughout theday Eating quicklycancauseastress response inthebody, which willinhibitdigestion(David, 2005) consumed includes the speedof eating and the rhythmand timing of eating throughout the day. Additionally, how aswhatoneiseating. How oneiseatingjustasimportant nourishmentis clarity, thusassistingthetherapeuticprocess through one’s abilitytothinkclearlyfrom both brains. et al.,2001;Mateljan, 2013).Eatingwhole,unprocessed foodswilltypicallyprovide energyand the difference between andprocessed eatingpreserved foodsvs.whole,unprocessed foods(Kweon to listenforgutbrainmessages.Careful attentiontothedigestionoffoodmayfacilitateawareness of affect mood(Rojek, 2003). tract promotes parasiticgrowth andcreates lessspaceinthegutforhealthybacteria,whichmayalso M, 2002;Gibson &Roberfroid, 1995;Jacobs etal.,2009;Rojek, 2003).Undigested foodintheGI thegrowthconsuming whole,unprocessed foods,whichinturnsupports ofhealthybacteria(Blaut, in awaythatreducesby inflammation,stress, foodcravings, andnutritionaldeficienciesinthegut supply ofserotonin, whichinfluences moodandGIactivity(Carpenter, 2012). It ispossibletoeat difficult emotions. Healthy gutbacteriahave beenshown toplaya role inmanufacturingthebody’s is aprobable correlation digestionandtheabilitytomanage between eatingfoodsthatsupport holds thenotionthatfoodismaterialneededtoproduce bio-chemicalsinthebody. Thus, there discovered several bio-chemicals, such as endorphins, involved with emotions, and Rojek (2003) diet canpromote dopamineproduction andprovide 2011).Pert asenseofcalm(Kruse, (1997) the gut that influence feelings, thoughts, and behaviors (Rojek, 2003). For example, a high protein growth, hormones,andimmunefunction(Rojek, 2003).Food canaffecttheneurotransmitters in likely occurringinawaythatwilloptimallykeepdown stress levels, tension,andinflammation. hunger ispresent and the body is fed with high-quality, nutrient-dense food, nourishment is most keep anindividualfeelingstressed duetothelow-nutrient andhigh-sugarcontents. When physical through sweetare tofindcomfort food.Eatingthesetypesoffoodswillmost likely stress andtrying information heldwithintheENS.Apersonwhoeatslotsofcakesandcookiescanexplore ifthey relationship withtheENS.Noticing how foodisdigestedinthegutcanleadtoadiscovery ofthe Eating processes informationphysically, emotionally, andcognitively. The Eating,Needing, Sensing (E.N.S.)systemincludespsycho-education aboutfoodandhow it Before ababy can communicate verbally, physicaland food isoftenusedtomeetevery Food canencourageonetofeel clear and grounded or to pollute the body and makeitdifficult One waytoaltertheENSischangefoodoneeats.Food isresponsible fortissuerepair, Attending tothetypeoffoodingestedandhow itisputintothebodyare waysofcultivating a THE ENTERICNERVOUS SYSTEM 113 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 114 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS a way that feels useful and digestible, and using new insight toletgoofoldwaysbeing. a waythatfeelsuseful anddigestible,using new Tracking (Love &Sterling, 2011). This occursby understandingsensations,interpreting the gut’s messages in a relationship withthegut’s sensationscanhelpdigestpastexperiencesthatfirstshaped personality can beanindicatorofinformation andemotionsheldwithintheENS(Boyesen, 2001). Cultivating the gut.Sensations inthegutcanbesignalsofstate ofthegutbrain,andcondition Sensing through whatdigestswell by paying attentiontothesoundsandsensationsofgut. themselves socially.constructed The ENS can then be a guide in learning about one’s uniquedesires ENS messages and needs might aid people in discovering who they are separate from how they have of whatactuallyfeelstobeinternallysatiating,instead one istoldexternally. Awareness of which feelsatiating.One cannourishthegutphysically andemotionallybasedonthediscovery relationships andeatingfoodsthatfeelsatiatingmaynow beexplored options inone’s asnew life. inthepresent. Finding isunnecessary past experiencesandfeelingsofunworthiness positive, loving withheld love andsupport. insightmayfacilitatetherealizationThis new thatholdingontothese nourishment tobefeltmightleadanexplorationofthepastandhow oneparent mighthave deeper understandingofoneselfanddifferent responses toENSmessages.For example,notallowing eating, needing,andsensingmightinitiateabodilyoremotionalrelease withinthegutthrough one’s brain. Boyesen (2001)usedtouchtofacilitateadischargewithinthegut.However, attentionto gas)canmakeitincreasinglystomach gurgles,relaxation, difficulttotuneinthegut crying, of input(Farjon, 2013).Eachchargewithoutadischarge(abodilyoremotionalrelease including music, tables,andcellphones)canbeexperiencedasachargewithinthebodyfrom anoverload needs, andsenseswithintheENS. The continuousstimulationfrom theenvironment (television, one learnstorelax inhow andtrust onechoosestonourishtheENS. Inflammation, stress, andcravingsmaydecrease whiletheabilityto regulate emotionsincreases as of whattheENSneeds,whetherthatisphysical(hunger)oremotional(loneliness,fear, anxiety). emotions. Learningthedifference between emotional andphysicalhungercanfacilitateawareness cream intoamomentoffeelinglonelyandnotwantingtodealwith tobringsweetness andcomfort precise cravingsandchoosespecificfoods(Konowitch, 2012). For example,onemay reach forice tofillanemotionalhungerwithfood,peopletendhave one doesnotneedfood. When trying the abilitytothinkfrom eitherbrain.Emotional hungerisdefinedasfeelingsofemptinesswhen for eachindividual.Some peopleexperiencestomachgurgles,light-headedness,oradecrease in felt withinthebodyasabiologicalneedforenergytofunction.Physical hungerfeelsdifferent learning thedifference between physicalandemotional hunger. Physical hungerrefers towhatis Needing in thegut. Insight anddifferent responses totheinformationheldinENScouldrelease stagnantfeelings of satiationcouldhelponetoexplore how foodisbeingusedtofillanemotional emptiness. needs.Forsurvival instance,fosteringawareness ofthespeedeatingateachmealandcues memories intheENScorrelated withthelove received inchildhood,current self-love, and emotional need.For therest oflife,foodcanbeconnectedtolove. Food experiencescantrigger STEPHANIE POLLOCK, MA Noticing offosteringawareness whatoneneedsisanotherpart oftheENS. This isdoneby The finalcomponentofworking withtheE.N.S.systemistodevelop awareness ofsensations in Nourishment cancomefrom positive foodexperiences orsurroundings andsocialsituations Excessive externalstimulationcanmakeitdifficulttoappropriately assesssuitablefoodintake, 1983; Vladimir &Dolmatov, 2011).Rapidcellturnover setupfor inthegutmakesitstructurally tocontainwithinthegut. sweating) ofwhatisnolongernecessary one’s screaming, emotionscanfosterabodilyrelease gas,gurgles,bowel (crying, movements, and to focus on sensations within the ENS can facilitate the arising of an emotional response. Feeling that have beeningrainedwithinthemusclesmaycontinue.Slowing down verbal communication continuously discusswhattheyare upsetabout,butwithout thechangeinbody, thepatterns potentially quick-healingnature ofthegutcouldleadto rapidtherapeuticresults. People can and intrapersonalinteractions. formsofself-expressionemotions heldinthegutcanbringaboutnew andalterone’s interpersonal is norelationship with theENS,itwilltaketimeto hear andunderstanditsmessages. Tracking from thegutbrain,depending uponthecommitmentofindividualtodothiswork. When there upon anddeepenedthrough time.It could takemonthsoryears tofoster awareness ofthemessages individual. gut brainanditsmessageswillbe different forevery session. This E.N.S. system can be utilized in every The progression of cultivating awareness of the and sensations.Additionally, noticingsensationsinthegutbrainrelates backtofoods andcravings. awareness ofhow foodaffectsoneselfintheeatingsection,anindividualisalsotuningintoneeds these three areas/questions: emotionally satiatinginthepresent andinthefuture. increase one’s abilitytoself-regulate through havingaclearer senseofwhatwillfeelphysicallyand which canfacilitateasenseofcalm.In cultivating arelationship withtheENS,onecanpotentially If one is feeling stressed and anxious and wants to feel grounded and relaxed, one may eat protein, sensations inthemoment,butnourishinggutwaythatindividualswanttheirgutstofeel. to sensationsoftension,ease,lightness,andheaviness.ENSlisteningisnotjustaboutthe 1996). In thissystem,onetunesintothenoises,gurgles,orlackofsoundwithingutandlistens Focusing isaboutnoticinghow you feelandhavingaconversation withyour feelings(Cornell, listening tosomethinginsideyou thatwantstocommunicatewithyou” (Cornell,1996,p. 15). Technique asitsfoundation.Focusing wascreated by Gendlin inthe1960’s and“isaprocess of allowing onetostanduptallerorpresent oneselfdifferently. subsequent feelingofrelaxation inthe gutbrainalsofacilitateschangeintheformofbody, thus gutcancontinueeachtimeonepaysattentiontofoodthatisbeingproperlyof anew digesting.A digest well cantransformtheENSby lesseningtensionheldintheviscera. Thus, thedevelopment well, onemayalterthegut’s abilitytofunction. The relaxation feltinthegutfrom eatingfoodsthat gut formingascellscontinuallydieandrenew.to anew By nourishingthegutwithwhatdigests change. Different choicesmadetonourishthegut,from fastfoodtohome-cookedmeals,canlead The ENShasthecapabilitytoregenerate over timeascellsdieandrenew (Gibson &Burke, Boyesen thatthemainhealingmechanisminbodyresides (2001)asserts inthegut. The Thus, there isnosetamount oftimetocompletethissystem.It canbeconsciouslytouched oftheE.N.S.systeminteractwithoneanother andareThese parts notseparate. When cultivating This E.N.S.systemofworking inabodypsychotherapy sessioninvolves payingattentionto The typeoflisteningintheEating,Needing, Sensing (E.N.S.)systemusestheFocusing S N E ensing: whatistheclientsensing/feeling? ating: whatistheclienteating? eeding: whatistheclientneeding/craving? Application THE ENTERICNERVOUS SYSTEM 115 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 116 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS of theclient’s eating. The therapistcaninquire: Does theclientknow thedifference between physical explore aclient’s withneedsandcravings. history This canoccuratthesametimeas evaluation In aclientlearnsthedifference thispart, between physicalandemotionalhungerthetherapist may Needing food canthenaffecttheoptimal functioning ofdigestion. levels canincrease becauseofthestress these negative beliefs induce(Eck etal.,1996).Beliefs around doesn’t nourishment (in whatever form it comes in: food, love, deserve affection), the body’s cortisol in terms of nourishment and love.clients believe they deserve If one possesses the belief that one nourishment and satiation on a regular basis? Rhythm with food can invite discussion about what client eatnormallyalldayandthenalargequantityoffood atnight?Does the clientrestrict client skipbreakfast? Doestwohoursandunderwhatcircumstances? Does theclienteatevery the a day. In theE.N.S.journal,onecanwritedown whenoneeats.Atherapist caninquire: Does the friends andfamilyornever wantanevent toend? can alsobeanindicationofhow onerelates toothers.Does onespeedthrough engagementswith clues around one’s capacitytocontainhappinessandsatiationinthebody. How onerelates tofood the receiving ofsustenance? The wayoneexperiencesemptinessandfullness withintheENScanbe giving oneselfnourishment?Does oneextendtheexperienceofeating,notwantingtoletgoandend client’s experienceswithfeelingsatisfied. Does onespeedthrough amealtoignore thefactthatoneis treatment planwithaclientinvolves practicalchangesineatingbehavior. one explore thestress inone’s Making through everything. a lifeandperhapsthefeelingofrushing separate occasion,onehadeatenthatsaladanditwasdigestedfinewhenslowly. This canhelp of being bloated after the meal and attributing this to the environment and pace of eating, as on a write down thatoneateasaladquicklywhilecompletingtasksatwork, notinginthejournalfeelings can besignsthatwhatoneiseatingdoesnotsitwell inthegutorthatoneiseatingtoofast.One could This willinvitetheclienttonoticehow foodisbeingdigestedinthebody. Bloating, gas,andcramping how fast,andwhattheinternalexternalenvironments are likewhile havinganeatingexperience. assign thehomeworkofkeepinganE.N.S.journal. The journaldocuments what theclientiseating, is mostlikelyinacontinuousstateofdeprivation. constantly noteatingenoughcandecrease one’s abilitytoconcentrateonanythingelsebutfoodasone Stuffingtrying to relay. foodinthe gutcanalsomakeitdifficulttofeelwhattheENSis Inaddition, over day? Does orundereatevery theclient eat foods knowing they do notfeelgoodinthe ENS? andaskquestionssuchas:Does theclientrestrictassessment/history intakeoffood?Does theclient be indicative ofhow else inlife. theyrelate toeverything The therapistcanbeginwithaneating is learningwhat,when,andhow theclientconsumesfood.Aclients’ relationship withfoodcan Eating system. therapy aswell habitsoflisteningtotheentericnervous tofacilitatenew what needsmore focusandexploration. This isaprocess thateachpersoncanwork onoutsideof brains. The therapistshouldnoticewhatareas couldusemore attentioninguidingtheclienttowards eating, needing,andsensingoffersinformationaboutthelevel ofawareness clientshave oftheirgut STEPHANIE POLLOCK, MA To cultivate awareness ofhow theclient’s choiceofnourishmentaffectsthem,thetherapistcan The main question in this section of the E.N.S. system is “what is the client eating?” The therapist The focusing questions in this section of the E.N.S. system pinpoint what the client needs/craves. The focusingquestionsinthissection oftheE.N.S.systempinpointwhatclientneeds/craves. Rhythmic eatingcanencourageonetolistenone’s physicalandemotionalgut needsthroughout Once clientsnoticehow quicklyorslowly theyare eating,therapistandclientcandiscussthe emotional hunger arises? As Boyesen (2001) connected gut sounds as insights from the gut brain, emotional hungerarises?AsBoyesen (2001)connectedgutsoundsasinsightsfrom thegutbrain, feed aphysicalneed? What doestheclienttypicallycrave, physicallyandemotionally, whenan or from desire. Does theclientknow how tofillanemotionalneedwithoutturningwhatwould emptiness, andhavinganeedtobefilled,feltlikeinthegut? Whatemotionsarisefrom this reflection? the client.In thisdiscussion,thetherapistcanask: When doestheclientfirst remember whatfullness, this craving.During intensification,thetherapistcaninquire aboutmemoriesthat maybearisingfor intense craving for sugar. The therapist can ask the client to focus on the gut and feel the sensations of an understandingofhow sensationsofneedsorcravingsfeelintheENS.Aclientmightdiscussan Bodying Practice (2004)canbeutilized tointensifywhattheclientisfeelingingutcome and emotionalhunger?How doestheclientexperiencephysicalandemotionalhunger?Keleman’s while nothaving to take action toimmediately ameliorate them. Reflection on sensationswithin gut usingthebreath asa tool tofacilitaterelaxation. Clientsthenlearntofeeltheir sensations heat, orpain. The therapist canteachclientstoslow down and listenforthesesensationsinthe responds toinputs. They mayexperiencerelaxation, softening,gurgles, gas,tension,bloating, heavier, grounded, spacey, sad, orjoyful? How didtheclient feelinthegutbefore fillingthebody? sensations inthegutdoesclient noticewhennourishingthebody?Does theclientfeellighter, how theyfeelbefore, mealsoractivities. during,andaftercertain The therapist canask: What the gutbrainhasbeenhappeningthroughout theE.N.S. system.Here, clientslearnhow totrack Sensing emotions astheycanbeexperiencedquiteintenselyifaclienthas nottunedintotheENSbefore. theclientintitratingthese unresolved thatthetherapistsupport itisimportant needsbegintosurface, have not allowed the emotions that the cravings are masking to arise. When repressed emotions and their cravings. This couldleadtoinsightashow theyallow orignore theirneeds.Often, clients (Cornell, 1996),whichasksclientstodescribesensationsintheENS andinitiateconversations with without havingtotakeactionwhileexperiencingacraving. This process utilizes theFocusing Technique other waysunrelated tofoodfindemotional satiation. can dive intowhatitwasliketonothave thatneedmet,cultivate acceptance oftheneed,andfind but never received them,sothenturnedtofoodquenchemotionalhunger. In therapy, the client fails tofindcompletion. One mightspeakabouthow onehadalwayswantedhugsfrom one’s parents Client andtherapistcandiscussemotionsthatarisewhenneedsgetmetorthechargeofaneed adult isawaytore-experience thefeelingofbeingtakencare ofby aparent. client’s motherfedthemtothe client whensickasa child. Thus, eatingthosefoodswhen sick as an therapist caninquire abouttimeswhentheclientatethesekindsoffoodandpossiblydiscusshow the timeaclientgetssick,cravingsforscrambledeggsandgingeralemayarise. example, every The activity canprovide anopeningforthetherapisttodelve intothemeaning behindthecraving.For externally withintheclient’s foodor bodyandlife.Aclientwithaspecificcravingforparticular to asenseoflackinone’s life(Rosenthal, 2008). can be asignof nutritional deficiencies in thegutthataffectfunctioningof the body orcontribute cravings can be viewed thesameway: as information about the current status oftheENS.Cravings The therapist can guide the client to process experiences of needs and cravings, either for survival The therapistcanguidetheclienttoprocess experiencesofneedsandcravings,eitherforsurvival The therapist instructs clientstolistenforwhatresonatesThe therapistinstructs intheirsystems by how thegut The mainquestionhere is“what istheclientsensing/feeling?” Tuning intosensations within Lastly, thetherapistcanguideclientstositwiththeirfeelingsandsensationsnon-judgmentally The therapistcanalsoinvestigate clients’ abilitiestoallow theircravingsandneedstobesatiated. Cravings canbedistinctive toeachindividualdependinguponwhatisgoingoninternallyand THE ENTERICNERVOUS SYSTEM 117 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 118 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS assumptions were madeastohow theeating,needing,sensing(E.N.S.)system works. made in thispaperareassertions accurate andeffective. lie inthat The limitationsof this theory and transformationforclients. Additionally, research further needstobeinitiatedonwhetherthe context thatdemonstrateshow working with the second brain can affect the outcome of healing brain intobodypsychotherapy. Investigations needtobecompletedontheENSinatherapeutic unique bodilyneeds.More research ontheENScouldprove usefulinincorporatingthegut very can leadtoanincrease inemotionalself-regulation through internallisteningandresponding to systeminwhichclientswillbeabletohear and understanditsmessages. enteric nervous This torelay.the ENSwhenanindividualmightbeunclearaboutwhat ENS istrying its messages.It couldbedifficulttoassessappropriateness atthebeginning ofa relationship with system canbeutilized whenonefeelsmore grounded inone’s skillsoflisteningtothegutbrain and is inalignmentwithaninnerknowingwell-being. ofwhatwouldbestserve oftheE.N.S. This part torelay.ENS istrying This gives onethechancetointegrateENSinformationandtakeactionthat appropriateness ofeating,needing,andsensing,onecanallow oneselftimetoreflect onwhatthe point thattheemotionfeelssatisfiedwhilenot overfilling thephysicalbody. Pausingtoratethe food tofillemotionalhungerifmindfulnessofsensesandneedsare present. physicalhunger? client feelstrue This process isentirely subjective. It couldbeappropriate toeat Furthermore, with a need to eatbecause the if the client is craving chocolate pie, is it congruent how appropriate itistohave thesesensationsandneedstobeeatinganentire chocolatepie. chocolate pie.In thatinstant,thisindividualcantakeapauseandask,onscaleofonetoten, alone notdoinganything,feelinganxious,needingcontact,andconsideringeatinganentire they are eating,needing,andsensinginthemoment.For example,apersonmightbeathome Appropriateness thatmayhave previouslysocietal constructs definedthem. pleasurable toeat.Reflecting uponsensationsintheENScanhelpclientsindividuatefrom the elsewashavingasliceandthatnotactually when eatingapieceofcakejustbecauseeveryone alignment withwhatisneeded.For example,atherapistcaninquire whataclientsensesinthegut can alsoexplore whatsensationsoccurinthegutbrainwhenclientchoosestofeedbody and emotionallynourishthemselves basedonexternallyreceived messages.Clientandtherapist there emotionsconnectedtotheeaseordifficultyofdigestion? stagnant inthegut?Does theclientfeelfluidmovement andhearnoiseswithintheENS? Are client sense in the ENS when digestion is occurring? What emotions arise when the client feels client isdigestingfood,emotions,events, andinformation. The therapistcanask: What doesthe movewhich sensations/rumblings asinformationabouthow through thegutbrain canserve a their abilities to sit with feelings of being full, empty,and observe or in-between. The quality with experience. Clientscantuneintotheirgutfeelingsthroughout aneatingornourishingexperience the gutcanbewritteninE.N.S.journalbefore, during, andafterameal,event, oremotional STEPHANIE POLLOCK, MA The therapistcaninvestigate whatitfeelslikeinclients’ ENS’s whentheychoosetophysically It is yet to be documented how the head brain could be affected by awareness of the gut brain Becoming aware of eating, needing, and sensing will potentially foster a relationship with the Craighead (2006)defineseffective emotionaleatingastofillanemotiononlythe As clientslearntobeaware toratetheappropriateness ofwhat oftheENS,itisalsoimportant Conclusion Definition ofbody psychotherapy. (2013, January). David, M.(2005). David, M.(1991). Da Silva, asmarkers ofpsychic G.(1990).Borborygmi work duringtheanalytic session. Damasio, A.(1999). J.,O’Mahony,Cryan, S.(2011). The microbiome-gut-brain axis:from bowel tobehavior. Craighead, L.(2006) Cornell, A.(1996). Carpenter, S.(2012). That gutfeeling. Caldwell, C.(1997). Boyesen, G.(2001).Bodypsychotherapy isapsychotherapy. In M.Heller (ed.), Boyesen, G.(1980). What isbiodynamicpsychology? Boyesen, G.(1974).Psycho-Peristalsis. tension. The abdominaldischargeofnervous Boyen, G., Reinshagen, M.,Steinkamp, M.,Adler, plasticity G.,Kirsch,J.(2002).Enteric nervous Blaut, M.(2002).Relationships ofprebiotics andfoodtointestinalmicroflora. Baker, D.(2005).Rationaleforusingserotonergic agentstotreat irritablebowel syndrome. Amir, S.,Brown, Z.,Amit,Z.(1980). The role ofendorphinsinstress: evidenceand counselor, andyoga teacher. She wouldliketothankChristineCaldwell, Danielle Carron, Agnés in bodypsychotherapy atNaropa University. She healthcoach,eatingpsychology isacertified Stephanie Pollock received hermaster’s degree insomaticcounselingpsychology withaconcentration BIOGRAPHY authenticity, andgenuinenessintheworld. which tounderstandtheirbodiesandbeablelive andinteractfrom aplace of congruency, able tointegratethegutbrainintotherapeuticwork andprovide lensthrough clientswithanew second brain into a session. Perhaps with knowledge and time, body psychotherapists will be pointfortheprocess ofincorporatingtheinsight asastarting outlined inthispaperserves and how ENSconsciousnessmayfacilitateadialoguebetween bothbrains. The E.N.S.system REFERENCES systeminallitswonder.nervous to thankalloftheresearchers andbodypsychotherapists whoinspired hertoexplore theenteric D’Abate, andEthan Fox inthewritingofthispaper. fortheirgenerous support She wouldalsolike Farjon, KimberlyLubuguin, Jacqueline Carleton,Etalia Thomas, Beit Gorski, KatieAsmus,Leah Retrieved from http://www.usabp.org/displaycommon.cfm?an=1&subarticlenbr=9 International Journal of Psychoanalysis, United States: Houghton Mifflin Harcourt. &Motility,Neurogastroenterology Quest Books. soul: thebodywe work with, Character, and development: dependenceonneurotrophic factors. of Nutrition, American Journal ofHealth-System Pharmacy speculations. Email: [email protected]. 5, 1:5-16. 41(1),i11-i16. Neuroscience &Behavioral Reviews, Nourishing wisdom. The slow down diet. The power offocusing. The feelingofwhathappens:bodyandemotioninthemakingconsciousness. Getting intouch:theguidetonewbody-centered therapies. 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119 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS 120 INTERNATIONAL BODY PSYCHOTHERAPY JOURNAL THE ART AND SCIENCE OF SOMATIC PRAXIS Locher, J., Yoels, W., Maurer, journey intothe D., Ells, food:anexploratory J.(2005). Comfort Leonard, B. (2007). Inflammation, depression anddementia:are theyconnected? Kweon, M., Takahasi, I.,Kiyono, H.(2011).New insightsintomechanisms ofinflammatory J.(2011). Kruse, Konowitch, M.(2012,May 30).Personal communication. King, A.(2011). inthetherapeuticencounter.When thebodyspeaks;tummyrumblings Kim, D.,&Camilleri,M.(2000).Serotonin: amediatorofthebrain-gut connection. Keleman, S.(2008,March). by Serge Interview Prengel [Audio Tape Recording]. Stanley Keleman, S.(2004). Keleman, S.(2003). Keleman, S.(1975). Jacobs, D.,Gaudier, E.,John, D., Vaughan, E.(2009).Non- digestiblefoodingredients, colonic Hirota, N.,Sone, Y., Tokura, H.(2002).Effect ofpostprandialposture ondigestionand Heuristic. (n.d.).In Meriam-webster’s onlinedictionary. Retrieved from http://www.merriam- D.,Zimberoff,Hartman, D.(2004).Corrective emotionalexperienceinthetherapeutic Gui, X.(1998).Mast cells:apossiblelinkbetween psychological stress, entericinfection,food Gibson, G.,Roberfroid, modulationofthehuman colonicmicrobiota: M.(1995).Dietary Gibson, A.,Burke, R.(1983).Gut regeneration by morphallaxisintheseacucumber Gershon, G.D.(1998). Gershon, M.(1981). system. The entericnervous Farjon, A.(2013,February 14).Personal communication. Esch, T., Stefano, G.,Fricchione, G.,Benson, H.(2002). The role ofstress inneurodegenerative Eck, M.,Berkhof, H.,Nicolson, N.,Sulon, J.(1996). The effectsofperceived stress, traits,mood Drossman, D.(2005).Brain imaginganditsimplicationsforstudyingcentrallytargeted STEPHANIE POLLOCK, MA and Hepatology, allergy andguthypersensitivityintheirritablebowel syndrome. introducing theconceptofprebiotics. leptosynapta clarki. diseases andmentaldisorders. states, andstressful cortisol. dailyevents onsalivary treatments inirritablebowel syndrome: aprimerforgastroenterologists. social andemotional significanceoffood. Neurochemical Research, and allergicdiseasesinmucosal tissues. com/your-gutneurotransmitters-and-hormones/ Journal ofPsychotherapy, American Journal ofGastroenterology, Retrieved from http://somaticperspectives.com/zpdf/2008-03-keleman.pdf keleman: formative psychology. Somatic perspective on psychotherapy, Berkeley, CA., psychologie.nl/vision.htm psychology-eu.com/stress.htm Metabolism,Drug microbiota andtheimpactonguthealthimmunity:arole formetabolomics. Science carbohydrates. absorption ofdietary webster.com/dictionary/system process. , 21(1),45-50. Journal ofHeart Centered Therapies, Your gut,neurotransmitters andhormones. 13(10),980-989. Stanley Keleman’s approach. formative andstress.The continuumofstartle Your bodyspeaks itsmind. 10(1), 41-54. Canadian Journal ofZoology, The Second Brain. 32(10),1749-1756. 27(2), 156-174. Neuroendocrinology Letters, Neuroendocrinology Journal andApplied Human ofPhysiological Anthropology 95(10), 2698-2709. The Journal ofNutrition, New York: Harper Collins,Publishers. Digestion, Food andFoodways: Explorations intheHistory New York, NY: Simon andSchuster. 7(2),3-84. Annual Review ofNeuroscience, 61(12), 2720-2732. 63(1),1-11. Psychosomatic Medicine, Retrieved from http://www.formative- Retrieved from http://www.formative- Retrieved from http://www.jackkruse. 23,199-208. 1401-1412. Journal ofGastroenterology Gut, 58(5),447-458. 54,569-573. 4,227-272.

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TABLE OF CONTENTS

04 Editorial Jacqueline A. Carleton, PhD

08 Self-Reflections on Art and Psychotherapy Terry Marks-Tarlow, PhD

10 Two Poems Jeanne Denney, BS, MA

ARTICLES

03 Shadows in the History of Body Psychotherapy: Part I Courtenay Young with Gill Westland

31 The Endo Self: A Self Model for Body-Oriented Psychotherapy? Will Davis

52 Toward an Integrative Model for Developmental Trauma Homayoun Shahri, Ph.D., M.A.

67 Awareness and Mindfulness in Consciousness-Centred Body Psychotherapy Christian Gottwald, MD

80 Helping the Body Grieve: A Body Psychotherapy Approach to Supporting the Creation of Continuing Bonds After a Death Loss Dyana Reisen, MA, CT

95 The Impact of Body Awareness on Subjective Wellbeing: The Role of Mindfulness Olga Brani, Kate Hefferon, Tim Lomas, Itai Ivtzan, Joan Painter

108 The Enteric Nervous System and Body Psychotherapy: Cultivating a Relationship with the Gut Brain Stephanie Pollock, MA

E UROPEAN EABP A SSOCIATION FOR B ODY- P SYCHOTHERAPY

Journal (ISSN 2169-4745)