Incor Ar The Internat volume twelve p or at t a ing ● nd Science of Som of Science nd u number one number s ass i onal Body Psychothera onal oci at ion for Body ps Body for ion ● spring 2013 ycho at t her ic Pric ap y Journ a xi s a l p p b a e uropean ody- sychotherapy ssociation y Journal y EABP for

International Body Psychotherapy Journal The Art and Science of Somatic Praxis 2 International Body Psychotherapy Journal The Art and Science of Somatic Praxis Elizabeth Marshall, Germany; Susan McConnell, USA; USA; Narelle McKenzie, Australia; LindaMarks, USA; Knighton, USA;Daniel USA;Mark Lewis, Ludwig, Kostka, Switzerland; USA,RaeJohnson, USA;Edmund Rubens Kignel,Brazil; Ljiljana Klisic,Serbia; René Lawrence E.Hedges, USA; Inge Joachim, Germany; Huerta Krefft, Germany; Regina Hochmair, Austria; Margit Grossmann, Germany; Michel Heller; Sibylle Glickman, USA;Herbert Grassmann, Germany; USA; Ruella Frank, Giuffra, USA;Mary USA;Gary France; Michael Changaris,USA; Will Davis, France/ Serbia; Fabio Carbonari,Italy; Fanny Chalfin,USA/ Barlow, Australia; Luisa Barbato, Italy; Sasa Bogdanovic, Peer ReviewChristina Bader, Board: Switzerland; Jeff Young,Courtenay UK. Joop Valstar, Netherlands; Halko Weiss, Germany; Maurizio Stupiggia, Italy; Manfred Thielen, Germany; Gustl Marlock, Germany; Frank Röhricht,UK; USA; Peter Levine, USA;ClorindaLubrano, Greece; Keleman, USA;Rubens Kignel,Brazil; AliceLadas, Netherlands; Ulfried Geuter, Germany; Stanley France; George Downing, France; LidyEvertsen, Brown, Switzerland; Fabio Carbonari,Italy; Will Davis, Germany; Marianne Bentzen, Denmark; Malcolm Netherlands; Jeff Barlow, Australia; Joachim Bauer, International AdvisoryBoard:Regina Axt, Marshall, KatySwafford. Lidy Evertsen, ChristineHayes, Michel Heller, Elizabeth Editorial committee:Robyn Burns, Nancy Eichhorn, Design/Layout: Ronald Jeans Cover illustration:Panta Rei (Eugène Brands) Cover Design: Joop Valstar, Chiel Veffer Production Team Rellensmann Christina Bader-Johansson, Thomas Harms, Dagmar [email protected] German Editorial Board: Elizabeth Marshall, [email protected] Managing Editor: Jill van derAa [email protected] Editor:Associate Diane Cai [email protected] Editor inChief:Jacqueline A.Carleton,PhD andpracticethrough ongoingdiscussion. theory exchange interdisciplinary withrelated fieldsofclinical field ofbodypsychotherapy as well asto encouragean the exchange ofideas,scholarshipandresearch withinthe The Journal’s promote andstimulate missionistosupport, the website www.usabp.org. for BodyPsychotherapy andcanbeordered through volumes ofwhichwere publishedby theUSAssociation It isacontinuationoftheUSABPJournal, thefirstten European AssociationforBodyPsychotherapy (EABP). Association forBodyPsychotherapy (USABP)andthe year. It isacombinedpublicationoftheUnited States is apeer-reviewed, onlinejournal,publishedtwicea The International BodyPsychotherapy Journal (IBPJ) VOLUME 12,NO. 1,2013 International BodyPsychotherapyJournal (formerly US Association forBodyPsychotherapy(formerly USAssociation Journal) The ArtandScienceofSomaticPraxis Publishers: Publishers: retrieval system,withoutwrittenpermissionofthepublishers. photocopying, recording, orby anyinformationstorageand form orby anymeans,electronic ormechanical,including ofthisjournalmaybereproducedpart ortransmittedinany Copyright (c)2013USABP/EABP. No Allrightsreserved. Printing ISSN Number 2169-4745Online ISSN2168-1279 EABP ortheirrespective Boards ofDirectors. necessarily represent theofficialbeliefsofUSABP, the NB The accuracyorpremises printeddoesnot ofarticles also befoundintheoriginallanguage. may accepted forpublicationinEnglish, thefullarticle originallywritteninanotherlanguagehasbeen If anarticle www.eabp.org/publications-journal.php Hebrew, Italian, Portuguese, Russian, Serbian andSpanish. the EABPwebsite inAlbanian,French, German, Greek, English language.Abstracts are ofarticles tobefoundon Translation TheonlineJournal ispublishedinthe Advertising: [email protected] Changes ofaddress:[email protected] Payment through banktransfer, AmericanExpress orPayPal. Two-year subscription:Members  Yearly subscription:Members  Printed singleissueMembers  Print subscriptions: The IBPJisavailable free online. Editor: [email protected] Correspondence Addresses FORUM Representative: Stefan Bischof COUNCIL Representative: Elfriede Kastenberger Zimmermann, Michael Heller Ethics CommitteeRepresentatives: Ilse Schmidt Scientific & Research Committee: Herbert Grassmann EAP Representative: Thomas Riepenhausen Treasurer:Eva Wagner-Margetich General Secretary/Vice-President: Jill van derAa President: LidyEvertsen EABP BoardofDirectors Duclos, Serge Prengel Members: Paul Briggs, Jacqueline A.Carleton, Marcel Treasurer: AnnLadd LynnSecretary: Turner Vice President: J.Giuffra Mary President: KatySwafford USABP BoardofDirectors Serbian, Sasa Bogdanovic; Spanish, David Trotzig. Portuguese, Teresa Ribeiro; Russian, Evgenia Soboleva; Marshall; Greece, Eleni Stavroulaki; Hebrew, RachelShalit; students; French, Marcel DuClos; German, Elizabeth Abstract Translators: Albanian,Enver CeskowithNokta Netherlands; Halko Weiss, Germany; Courtenay Young, UK. Maurizio Stupiggia, Italy; Jennifer Tantia, USA;Joop Valstar, Asaf Rolef Ben Shahar; Israel; Sharon Stopforth, Canada; Röricht, UK; Talia Shafir, USA; Homayoun Shahri, USA; Marc Rackelmann,Germany; Marjorie Rand,USA;Frank

EABP [email protected] www.eabp.org USABP [email protected] www.usabp.org www.eabp.org/ibpj-subscribe.php 17.50, Non-members  30, Non-members  55.00, Non-members  35 35 20 20 60. 60. the principlethateverything moves,changesandtransforms allthetime(Heraclitus,Plato,Aristotle). The imageonthecover isanoilpaintingbyEugèneBrands, entitled‘EverythingStreams’.Itrefers to‘Panta rei’, PANTA REI T ab le of C of le volume twelve 74 56 42 28 27 Therapies. 15 8 ARTICLES 4 P. JózsefVas, MD,ECPandNoémiCsászár, PhD,ECP Tandem Hypnotherapy Debra Greene,PhD Exploring ContributionsfromEnergyMedicine Expanding theDialogue: Livia Shapiro A Yoga BasedandBodyCenteredApproachtoCounseling Yoga BasedBodyPsychotherapy: Morit Heitzler, MSc Containment inTrauma Work Broken Boundaries,InvadedTerritories -TheChallengesof Salita S.Bryant,PhD.,MFA A spaciouslife Claire Haiman,PsyD Bridging theSplit:IntegratingPsychodynamicandBody-Centered (Translated fromtheGermanbyElizabethMarshall) Sibylle HuertaKrefft,MA,ECP Sense andSensibilityinSupervision Jacqueline A.Carleton,PhD Editorial ts ten on

● number one number : ● spring 2013

3 International Body Psychotherapy Journal The Art and Science of Somatic Praxis s s Editorial research. I asked if it carried a stipend. It did. Istanbul plan nixed, I joined the program. xi xi a a Its director, a psychoanalytically oriented psychiatrist, soon pointed out to me that I was Volume 12, No. 1, 2013 far more interested in the patients than any of the young psychiatrists in the program, ic Pr ic Pr who mostly wanted to figure out what medication to prescribe for them. He opened doors at at The title of the last USABP national conference was “The Body in Psychotherapy: The for me to take all the classes with the residents in psychiatry and then to participate in Pioneers of the Past, the Wave of the Future”. In our last two issues, we honored many of Columbia’s psychoanalytic training clinic as a research fellow. the pioneers of the past and will certainly continue to do so in subsequent issues. But, the themes of this issue represent some waves of the future, the expansion of the parameters In the meantime, I was discussing all this with my Reichian therapist, also an MD, who of body psychotherapy itself and its integration with other fields of psychology and other agreed to train and supervise me privately while I sought certification from a postgraduate branches of scientific endeavor. psychoanalytic institute that trained PhD’s and MSW’s. I formulated a dissertation topic at Columbia to reflect my interest in Reich’s work but not betray my personal interest in Having just reached the age of 70, I shall invoke the elder’s privilege and begin this editorial the topic. Investigating Reich’s ideas on child rearing allowed me to interview his wife, nd Science of Som nd Science of Som on a personal note that transports us back a few decades… almost half a century. translator’s wife, and many of the senior Orgonomists without entering into any of the t a t a sociopolitical issues surrounding his work and eventual death in a U.S. prison. In the It was my 25th birthday and I was heartbroken: I had recently moved to New York from course of these extended interviews, I was interested to find out that I was not the only Boston and had neither a PhD nor a baby. My loving husband, who had been my childhood PhD candidate being privately trained (instructed and supervised) by an Orgonomist. The Ar The Ar

sweetheart, was deeply involved in his PhD program in physiological psychology, so it was easy to hide from him that something was dreadfully wrong. Whenever he was gone, I Illustrating how far our field has come, we open this Spring 2012 issue with a penetrating went to bed. contribution to the training of body psychotherapists by Sibylle Huerta Krefft entitled ournal ournal “Sense and Sensibility in Supervision”. Relying on neuroscientific research, she describes J J It was that simple. I spent most of the time in bed. When I couldn’t stand the boredom relational, embodied supervision focusing on emotional resonance to enhance the learning anymore, I confessed what was really going on, and I heard my husband on the phone process. She also sees it through the eyes of chaos theory relevant to non-linear self- to my best friend trying to figure out what to do with me. She told him about a kind of organizing systems. In that light the responsibility of the supervisor becomes to introduce psychotherapy in which you took off all your clothes and screamed into a pillow. This just the right amount of perturbation to allow the self- organization of the supervisee to was a more intriguing option than the drugs then circulating (mostly pot and LSD) that briefly enter a period of chaos followed, hopefully, by re-organization at a higher level of scared me and the alcohol that just didn’t do it for me either. It sounded weird, but having complexity. Quoting Will Davis she reminds us to ask “How?” rather than “Why?” as sychotherapy sychotherapy participated in one of Al Pesso’s early groups at the Charles Street Meeting House in she explores embodied tutelage in this context. She emphasizes that learning takes place P P Boston, it also made more visceral sense to me than just talking to someone. optimally in a relationship which includes both bodies and emotions: learning, thinking, language and the body are inseparable. If, as she states, “relationship shapes communication ody ody B B So, once a week my husband dragged me out of bed and took me to a Reichian therapist and vice versa, and non-verbal communication comprises 70%-80% of communication”, who looked into my eyes and told me at the first meeting that I had been terrified all my the language in which we communicate the remaining 20% - 30% loses its heretofore life. And, he did indeed plop me on a couch with pillows, force me to breathe more deeply enormous importance. than I ever had before, and kick my legs and scream into a pillow while he (sometimes painfully) massaged hypertonic musculature. Six months later I was no longer clinically In the late 60’s and early 70’s much of body psychotherapy seemed to have “thrown out the depressed and, interestingly (for the quantitative, evidence-based folks), my score went up baby with the bath water”, ignoring advances in the wider psychotherapeutic community 100 points on a retake of the Graduate Record Exams, with no prior preparation. But I and hunkering down into competing training institutes which were considered and nternational nternational I I was far from finished. I began studying Martha Graham technique intensely and, trying considered themselves countercultural, New Age, or one of the many other epithets that to figure out what I would study in graduate school, with a BA in history and a couple of frequently characterized them. That was certainly my experience. I never told psychoanalytic years of study/research in International Studies at MIT. or academic colleagues of my personal or clinical interest in Reich (the only book of his in the Columbia Psychoanalytic Clinic library at that time was Character Analysis), and my I was beginning to be interested in psychology, but Columbia’s psychology PhD program Reichian colleagues, I knew, thought that just talking with somebody was of no help at all. didn’t seem to be about people so I enrolled in a program in sociology and Middle East So, for more than 20 years, I kept my professional life housed in two separate castles, the Studies (in the meantime I had learned Turkish at a Princeton-NYU summer institute). walls of which were only breached in my private practice, in which they were seamlessly One day, after I had passed my orals and language exams and was making plans to go off to combined. Istanbul to hole myself up in a library and analyze Ottoman novels, I received an intriguing call from the director of a program at Columbia’s College of Physicians and Surgeons Claire Haiman takes on this issue in “Bridging the Split: Integrating the Psychodynamic for psychiatrists and social scientists to learn each other’s disciplines and collaborate on and Body-Centered Therapies” utilizing a grounded theory approach (exciting to me as this

4 5 s s was not on the horizon when I was structuring a qualitative dissertation myself). Structured whole field has grown along beside us, usually referred to as energy medicine. Its abundant xi xi a a interviews with 11 New York City area therapists who were trained in both body-centered literature is exemplified in my own library, which devotes more than two shelves to housing psychotherapy and psychodynamic psychotherapy produced three different ways of the outpouring of books in this field. Dr. Green outlines a clear, multidimensional model ic Pr ic Pr handling the bridge/split. All were initially trained in psychodynamic psychotherapy, but focusing on five principles of the etheric body (the power supply, the replica effect, the at at one group left that training and moved almost exclusively into body-centered work while a blueprint effect, the interface effect, and the internal senses), discussing areas of overlap second group integrated the two, and a third group maintained two separate practices, one with and application to body psychotherapy in hopes of forming an energetic bridge body-centered and one psychodynamic. She provides quotations from them illustrating between energy medicine and body psychotherapy and simultaneously opening a mutually each of these three positions as each therapist uniquely practiced it. This is the richness of beneficial dialogue. contemporary qualitative methodology. Noemi Csaszar and Joszef Vas explore yet another dimension in their article entitled Moving into the challenges of clinical practice, Morit Heitzler brings to our attention “Tandem Hypnotherapy” (THT). Tandem Hypnotherapy is practiced in groups. A the boundaries that are front and center in the body psychotherapy community as well as therapist and co-therapist work together with each participant singly. The co-therapist nd Science of Som nd Science of Som the larger psychotherapeutic community of trauma therapists with her thought-provoking goes into trance with the patient while the main therapist holds the space and attends to t a t a article “Broken Boundaries, Invaded Territories: The Challenges of Containment in the group as a whole. A mutual attunement evolves during THT. The authors believe that Trauma Work”. She explores the paradoxical nature of boundaries and containment as by using THT the symptoms of pre/perinatal traumas can be replaced with an associative they are and must be played out in the relationship between therapist and client. As an mode of prenatal experiencing which includes acceptance and love. The essence of THT The Ar The Ar

introduction, she analyzes an awkward initial exchange with a client that occurred prior is viewed as an integration of touch, trance, and transference. Three case vignettes are to her sophisticated and nuanced understanding of both internal and external boundaries. presented to illustrate how THT works. Utilizing her work with this challenging client, she demonstrates in two vignettes the ournal ournal complexity of working with the invaded boundaries that are an inevitable part of early The ramparts of both castles (psychoanalysis on the one hand and body psychotherapies J J trauma. Her riveting description of the client’s attempts at seduction with money and on the other) were being slowly dismantled in the 90’s by neuroscientific research, power, accompanied by rage, leads ultimately to a pivotal embodied enactment. The especially that involving fMRIs. And, many body psychotherapists, certainly including therapist was able to sense through her own body both what the client experienced and me, were tiring of their narrow, physiological focus. Many body psychotherapists embraced how she herself had “the capacity to lose and regain my sense of self” in order to guide relational psychoanalysis and integrated it into their work, acknowledging the effect of their mutual journey. language on the body as well as of the body. The people who had straddled both worlds all along were publishing their views and our field was more and more interested in sychotherapy sychotherapy As illustrated in Dr. Haiman’s article, body psychotherapy, along with acupuncture, listening. The EABP had been in existence for several years, and the turn of the century P P homeopathy, naturopathy, etc., has long been considered, even by many of its practitioners, saw the inauguration of the USABP. Both organizations have grown steadily and produced “alternative”, or “complementary”. Body/somatic psychogtherapy was not part of well-attended conferences in alternate years. The USABP Journal started as a very small, ody ody B B psychology curricula nor was it given a place in medical schools. Just as mainstream desperate effort to increase communication within our field and has grown into the jointly medical schools are now beginning to teach Integrative Medicine, mainstream psychology sponsored, professional journal you hold in your hand or read on your computer (or has begun to integrate approaches that would formerly have been considered outside of iPhone or iPad) today. Graduate schools are teaching somatic psychology, and modalities acceptable standards of practice. Integration is the guiding paradigm of “Yoga Based Body such as Somatic Experiencing and Sensorimotor Processing are incorporating the latest Psychotherapy: A Yoga Based and Body Centered Approach to Counseling”, in which findings of neuroscience into their curricula, which are in turn being accepted for credit the author, Livia Shapiro, strives to integrate on a theoretical level two approaches to by undergraduate and graduate programs. It’s an exciting moment for education and the body, the outcome of which she calls Yoga Based Body Psychotherapy. She marries innovation in the field of body psychotherapy; old, new, and the once occult are all making nternational nternational I I Susan Aposhyan’s developmental movement sequence, the Five Fundamental Actions their way into the fold. We celebrate this broadening and widening with a brief but relevant with Anushara Hatha Yoga’s Universal Principles of Alignment. She describes each system poem from poet and psychotherapist Salita Bryant, entitled “A spacious life” reflecting the in detail and shows how the introduction of yoga postures within the framework of the value of mindful spaciousness in our work and in our lives. Interaction Cycle supports change and transformation, thus broadening the scope of body psychotherapy’s already eclectic stance. Jacqueline A. Carleton, Ph.D. Another jurisdiction considered with ambivalence by some even within body psychotherapy New York City has been the realm of energy work. Just what do we mean by “energy” anyway? Debra March, 2013 Greene explores this question in “Expanding the Dialogue: Exploring Contributions from Energy Medicine.” Many of us, especially in the Reichian tradition, have worked with concepts and techniques of energy all our professional lives. But, in recent years, a

6 7 8 International Body Psychotherapy Journal The Art and Science of Somatic Praxis © Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 12,Number 1,2013pp8-14Printing ISSNNumber 2169-4745Online ISSN2168-1279 International BodyPsychotherapy Journal TheArt andScienceofSomaticPraxis SIBYLLE HUERTA KREFFMA,ECP that is supported by thesevariousthat issupported disciplines. theknowledge tointerweave aboutlearningwidening theirhorizons, Iwouldliketotry laying claim to areas of philosophy, are and where finding themselves open supervisors to interdisciplinary, encompassingnotonlyeducationalscience andpsychology butalso p. 222).At this criticaljuncture where neuroscience research findsitselftobelargely share thesamecharacteristicsthatdefineotherlivingtissuesinbody-proper” (2003, cells—thatproper; (…)andthatthemindarisesfrom orinbiologicaltissue—nerve it interacts;thatduetothemediationofbrain, mind isgrounded inthebody- “that (…)themindarisesfrom orinabrain,situatedwithinbody-proper withwhich will oreven ofthesoul. The neurobiologist AntonioDamasio reaches theconclusion: neuroscience research. Neurobiologists stillargueaboutthelocationof themind,offree the bodyorwhetheritshouldbeviewedseparatelyisan ongoingpreoccupation within of learningapparatus,isjustapart Whether thehead,whichisostensiblyprimary ignore the connection of the senses to making sense of learning. Learning is experiencing. role intheprocess oflearning.It isnolongerpossible even forthenaturalsciencesto Weinheim, BRD. Translated from theGerman by Elizabeth Marshall 1 First publishedinGerman inissue 1/2009ofthejournalSUPERVISION by the Beltz Publishing Group, work- andstress-related illness,burnout. increasingly important. In ofthecontinualrisein stress-related view illnesses,thisapproach isbecoming andatthesametimetocautionagainstanalltoogreat simplification.for supervision change. The goalofthispaperistoclearlyoutlinetherelevance ofbodypsychotherapy help toalleviateexaggeratedexpectations.Critical instability, for infact,isnecessary Utilization ofthepulsationmodelbodypsychotherapy canalso,onthecareer level, term reduces anxietyleadstoburnout. learningpotentialandlong-termperformance Learning isabodilyprocess andcanbedescribedneuroscientifically. Stress intheshort involvedthe parties andismosteffective whenthebodyandemotionsare engaged. isrelated tothestructure oftherelationshiplearning undersupervision, between and theoretical approach through recent neurobiological findings.Learning,including dimension ofbodypsychotherapy, whichhasreceived foritsempirical decisive support knowledge andskillsthrough the addresses This article enhancingsupervisory

K eywords: bodypsychotherapy, supervision, neurobiology, learning,unlearning, Through developments inneurobiological research, thebodyhasreclaimed its Sense andSensibilityinSupervision By SibylleHuertaKrefft Submitted 21March 2012;acceptedAugust 2012 Abstract 1 MA,ECP doesn’t care tolearnthingsthatdon’t interest it. and shouldmakethereader curious—a valuable illustration,asthebrain,research tellsus, skills. development ofsupervisory thoughtThis paperisintendedasanimpetus forfurther of neurobiology combinedwithabody-orientedattitudecouldleadtothefurther familiar parametersandyet stillpresents aslight challenge,Iwillshow how theknowledge research teachesus that we learnbest information thatwe are able to connect already integration ofbodyknowledge anditspractical applicationsforthesupervisor. of this approach. Now, through neurobiology, we are confronted with the question of the anew for teachersonthebasisofbody-orientedhumanisticpsychology confirmsthepositive effects holistic approach. Bulling’s (1999)onthedevelopment ofaconceptsupervision dissertation by bodypsychotherapists (Huerta Krefft, 2006)showed alsohighlyvalued a thatsupervisees aspracticed Astudyofsupervision affective communicationinsupervision). in supervision, onthebodylevel various ways(bodylanguage,energeticdynamicsofsystems,interventions is nothingallthatnew. Satyr, Fallner, Levold, Lambeletetal.have addressed thesubjectin too,including the bodyand theemotions in thelearning process the field of supervision, disposal usefulskillsforworking withtherelationship between learningandthebody. In neurons asbeingcorrelated withintuition. the interpersonal learningprocess (Bauer, 2005). We could alsotaketheactivityofmirror something isalready wrong. Stress inhibitsmirroring activityandthusimpedes onelevel of of itsown accord andbelongs tothebasichumanconfiguration. If itismissing then Thus, intuitive understanding occurs before any conscious reflection. Resonance happens pain insomeoneelsetriggers theactivityofone’s own painsensation mirror neurons. a basalmotoriclevel (Bauer, 2005). On thesensationlevel, ofbodily themere observation precinct, withoutmishap. These actionsare coordinated beneathconsciousawareness, on situations thatdemandhighlycomplicatedcoordination, suchasinacrowded pedestrian are beingmobilized. This activation makesitpossibleforindividualstomove intandem Beneath consciousness, the relevant motoric action schemata of one’s own mirror neurons with humanbeings—are activated and“firing” (Bauer, through theobservation 2005). others. thishasbeenconfirmedinexperimentsThe mirror neurons oftheobserver—and sensations andemotionsthatariseexclusively by ofactionsperformed from theobservation experiment withapes,Rizzolatti’s teamdiscovered aneuralsystemthatmirrors bodily learning(modeling). of observational duringanThrough anaccidentalobservation neurobiologist Giacomo Rizzolatti (Bauer, paradigm thesupervisory 2005)supports the relationship level intheactivityofmirror neurons. This discovery by Italian to establish connectivity and resonance. We couldfinda neurobiological correlate of entirely although itismirrored transferred of the supervisor inthe efforts tosupervision, oftherelationship thisfigurestructuring inthetherapeutic setting.Certainly can’t be and Donati (1994)attribute50%oftheenduringandpositive effectsoftherapytothe learning dependstoagreat extentontherelationship involved. between theparties Grawe The wholefieldoflearningislargeanddifficultto evaluate. Whileneuroscience For decades,bodypsychotherapists andpsychosomatic practitionershave hadattheir As we know from our own experience and now find corroborated by brain research, Including andtheEmotions theBody Learning inRelationships SENSE ANDSENSIBILITY

9 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 10 International Body Psychotherapy Journal The Art and Science of Somatic Praxis SIBYLLE HUERTA KREFFMA,ECP psychosomatician andstudentof Thuere von Uexkuell, Werner Geigges (n.d.,p. 248). We turn, thedifferent systemlevels represent foreach otherenvironmental aspects”, writes between organsand theorganism,aswell asonthepsychic andthesocialsystemlevel. In aspects appliesonallsub-system levels; soitisalsobetween cellsandorgansinthebody, permanentinterplaybetween asystem andrelevantholistic process. “The environmental aspect ofacascade of communicative processes. Let’s take a look at communication as a is more thanjustabitof bodylanguage,whichonlyrepresents theconsciously perceived beyond theword itself. This isnotonlywhatwe callbodylanguage. The analogue content within anegative contourinrelation tolanguage. This remainder containseverything language isbackwards—the ofcommunicationshouldnot be contained non-verbal part with therest ofcommunication,thisnon-verbal portion. To focuscommunicationon definition contains a fallacy: language follows on, is grounded in and always connects dichotomy oftheverbal and“the rest” (theso-called non-verbal). Furthermore, sucha because definingtheanaloguecontentasthusandcastrating itonlyhardens theapparent as thenon-verbal andpackedawayinthechest oftechniques.But thisdoesn’t work, shaping oftheremaining 20%to30%,thelanguage. The analoguecontentisdefined communicated content.Aftersuchapreamble, thefocusisthenonmeaningand of communication)whichcomprisespercentages ofbetween 70%and80%ofthe content of communication (the relational content which includes all non-verbal aspects oftheanaloguecommunication trainingistheemphasisonoutstandingimportance to ornot,itwillbemirrored andlearnedonabasallevel by theclientsystem? boundariesinfluencetheclientsystembecause,whetheronemeansitand abilitytoassert realizing it?Does thesupervisor’s self-care, solution-orientedacting,emphaticempathy transfer thisprocess ofmirroring more totheconsciouslevel? Whatare we without learning of the basal mirroring occurring in the client system, howin supervision can we help to negatively connotatedmirroring processes (e.g.bullyingorharassment)?Aware aswe are mirroring processes (e.g.asaresult ofunemployment), orwhoare involved inonly with theclientsystemonabasallevel)? What happenstopeoplewhoare excluded from this. How canwe protect ourselves from unwantedmirroring processes (identification body psychotherapy educationalcurricula.For additionalproblems arisefrom supervisors, the attentive andpainstakinguseofvegetative identificationistherefore of anintegralpart levelthis without of a awarenesscertain are well known (Boadella, 1991) and training in systems, thatofthetherapistandclient” (1992,p. 94). The dangersofhandling organismic processes oftheclient. The reason forthisistheorgonoticinteractionofboth “a asanindicationofthe conditioninwhichthebodyperception of thetherapistserves phenomenon. About vegetative identification,Knapp-Diedrichs elucidatedthefollowing: psychotherapy, theconceptof“vegetative identification” describedformany years asimilar only ever be—similar. In ofthis,we view mustbecareful andalwaysseekfeedback.In body clearer that neural mirroring works as if it is the same thing, but that it really is—and can to prevent mirroring activityfrom beingperceived asaone-to-oneprocess. This makesit develops andwhichguidesone’severybody personalway) informationprocessing inavery (somethinglikeaninnerroad mapwhich asusedinsupervision the “innerconstruction“ Relationship shapescommunicationandviceversa. Arecurrent phenomenonin It seemstomehelpful,ifnotatthispointindispensable,bringintheconceptof Learning Process asaBodily organisms indynamic andenergeticmotion. language literally, word for word, so to speak; we humans are not trivial machines, but essential inintercultural communication.In conclusion,Iwarnagainstinterpreting body and todistinguishbetween sensation,interpretation andexpression. This isparticularly non-judgmental feedback. Together, we mustlearntocommunicate inadifferentiated way levels ofonly learntoopenupnew ofcommunication withoutanxietythrough thissort Icanlearning todifferentiate andinterpretation. between As asupervisee, observation supervisor, andinterpretations through inmyobservations develop askingandthen trust is essentialtoaskforfeedbackreally understandbodylanguage.Icanonlythen,asa or scratchingofthehead.Precisely becauseitseemssosimpleandcomprehensible, it Also, gestures canbeextremely explicit:athrowaway movement ofthehand,ashaking the emotionalcontentisimmediatelyobvious: “my colleaguestabbedmeintheback!” develops through experience. Where body language has been adapted by spoken language, gestures globally comprehensive and a certain expression of feelings and sensations. It tangled expression. untiesomedealing withitrespectfully hasoftenhadtheeffectofhelpingthoseIsupervise cannot breathe outandinthiswayproduce sounds.Paying attentiontobreathing and “loses” theirvoice, thismeansina figurative mannerthatittakestheirbreath away—they because thediaphragmactsasakindofbellows forthevocal chords. When somebody In addition,fullbreathing and a relaxed diaphragm make an indispensablebasis for speech, role inthecreationof thebodyplaysanimportant of asonorous andwell-modulated voice. the body’s constitution. For and oral segments openness in the cervical instance, a certain itself aformofexpression oftheorganism,asonapurely physicallevel itisdependenton be justtooslow! it. Andifwe hadtoaccesswhatwe know through knowledge, we wouldbe lost. We would simultaneously onmanylevels oftheorganism. We learnmostlywithoutbeingaware of other. Learningcannolongerbeclearlydivided,located,deduced. takesplace of happinessare beneficialforone’s cognitive powers. strengthen orweaken thoughtprocesses, anditshouldnotcomeasasurprisethatfeelings dramatization androle playing.According to Damasio (2003)feelings can ofthemselves forexample,structured caseconferences,This wouldindicatesupport, whichinclude view, this means thatonecannotoveremphasize repeated, sensoriallyaccentuatedreflection. sequence offeelingsorthoughts. Thereby theprincipleof“use itorloseit” isoperative. from daytosituations,inwhich,forexample,asmellorsoundcantriggerwhole together andtheselinksare reinforced by constantrepetition. We allknow thiswell enough relevant objectinthememory. Thus, bodysensations,emotionsandthoughtsare linked bodilystates,there withcertain developsthat congruent associatively amarking ofthe (2003) showsofbodysensations,emotionsandthoughts.He thisinterweaving postulates circularity withinthewholeorganism. With hisconceptof“somatic markers”, Damasio one-man show from thebraintorest ofthebody, butaccording totheprinciple of also. Asininterpersonalspace,thisdoesn’t happenintraorganismicallylikeaneuronal its effectininterpersonalspaceand,asneurobiology demonstrates,inintrapersonalspace must claimthisforcommunicationandlearning,too. Communicationtakesplaceandhas Let usnow turntobodylanguage. This comprises learnedandculturallydifferentiated The spokenlanguageasamediumofinformationforcommunicationandlearningisin Learning, thinking,languageandthebodyare inthissenseinseparablefrom each Unlearning pointof isalsoadeeplyhumancharacteristic. Regarded from asupervisory SENSE ANDSENSIBILITY 11 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 12 International Body Psychotherapy Journal The Art and Science of Somatic Praxis SIBYLLE HUERTA KREFFMA,ECP versa (seefigure below). gathering (b=inward movement) andthefollowing outward movement (a)andvice night, etc).Pulsatory development takesplace only through thecontinuous process of rhythm, digestion, lifephases,etc)andinnature (changing ofthe seasons, day and processes in the human body (sleep-wakecycle, ofthe pulsatory heartof the observation parallel intheconceptofnon-linearmovement ofthehumanorganismonbasis thatdevelopment occursinphases.Init isimportant bodypsychotherapy, we finda asanevening stroll. Fromgood ideatoorganize supervision aneurobiological viewpoint one has learned (Kistler, 2004).If we take this information seriously, then it couldbea movement phases,whenresting orsleeping.If inputfollows inputthenoneloseswhat with thealready known andthefinalanchoringinbraincanonlytakeplacenon- by 25% (Schule, 2006). It has also been shown that the process of neural interconnecting intomovement,energy potentialisconverted the bloodsupplytothebrainisincreased blood circulation in the brainandtherefore facilitatesthinking. While only40% of our of order andstatesofdisorder. Out ofapparent order chaos,anew already beginsto are another significantaspectofthesame process. Thismanifests intheinterplayofstates a profound change ofperspective. trapped innarrow thinkinghasproven helpful. very The reevaluation outlinedabove offers have beenblocked by anxiety. whoareThis shiftinattitudefor clients undersupervision in thealleviationofstress liesthechanceforcreative solutions,whichwouldotherwise have intheirprofessional asenseofmeaningfulness development. AsIhave already shown, they realize thattheyneed not be permanently in a stateofexpansionandoptimization to necessary. From practical experience, I see how relieved and reassured many clients are when to dealwithsuchperiodsatwork lessjudgmentally andtorecognize thattheytooare self-regulation asbeneficialbothforhealthandlearning,thismakesiteasierclients of agoodbalancebetween thephasesofinward andoutward movement andifwe value used forare-evaluation we firstestablishtheprinciple ofthesituation.If insupervision Shifting thefocuslikethisonprofessional setbacksorphasesoflow achievement canbe that manypeoplehave: gettingoutofthesnowdrift hasstrongly positive connotations. Will Davis). This imagehasproved It memory useful insupervision. linksuptoasensory can work analogyisfrom uptherightmomentumtoroll outofthedrift(thiswonderful further. Instead, oneneedstoalternatebetween acceleratingandrolling back,sothatone just hitthegas.It is well-known digyourself ineven whathappensifyou shouldtry—you figuratively, togetacaroutofsnowdrift, if you are trying you needtodomore than Neurobiology has, with all intents and purposes, proved that movement stimulates The so-calledtransitional phenomena intheprocess of organismicself-organization Therefore, development needs both embodiment and expression. To put it more (Huerta Krefft, 2005) Learning inMotion Email: [email protected] andhealth. on thesubjectofburnoutand isatrainerattheintersectionofsupervision private practicein Freiburg since1988,focussingon bodypsychotherapy. She lectures in supervision” (Freiburg, 2006).She hasworked asahealingpractitionerinherown is theauthorofmaster’s thesis“Checktheflow— bodycommunicationaspects Phil. andfreelance Supervisor MAfrom theEvangelische Hochschule Freiburg. She Sibylle Huerta Krefft is an historian and specialist in German studies with a Mag. BIOGRAPHY lighttotheoldMarxistperhaps bringnew axiomthat“beingdeterminesconsciousness”. tomakingsense,whichwouldand wisdom.Sensibility leastgive birth wouldatthevery canlearntoappreciate theirbodiesasasourcefrom ofinsight thesenses,supervisees do. In aworking environment thatisbecomingprogressively more andmore alienated andutilized,knew which,usefully, canhelpustoformulategoodargumentsforwhatwe the tipoficeberg. to say“no” tothesystem,butnot to say“yes” to themselves. The issueofburnout is just work-related.part At themomentitseemsthatbodiesofworking peopleare learning only comeinthrough thebackdoor, sotospeak, intheformofillness,whichisatleast systems to look at the system of the body. can the bodies of those in supervision Otherwise thinkingandcreates spaceforsynergy.supervisory It helpfulwhen considering canbevery does theorganismorganize itsenergy?Not why, buthow?” (Davis, 1991),converges on the mostpositive effectofgroup supervision. special significanceCHANGEhasfortheteachersinvolved—they sawprecisely therein Interestingly, Helmuth the supervisor Bulling the (1999) points out in his dissertation becomes a precondition for self-organization and learning and, thus, for change. tofacilitatechange.Movementwhich isnecessary outofthemotivational equilibrium Supervisors canreadily translatethisintotheconceptof“inducingdisorder inthesystem”, Schoenbein etal,2003,296).Instability thusbecomesanexpression ofincipientchange. well asphysically, lifeappearstobeacascadeofadaptive order-order transitions” (Schmid- environment becomes the touchstone for mental and physical health. “Psychologically as as it is for neurallearning processes. The variability of the organism in relation to the and protecting thestatusquo. amplitude) forphysicalhealth(e.g.heart This isastrue of synergy, whichdescribestheneedfor“critical instability” between exploringthenew equilibrium wouldleadtostagnation. order todisorder andviceversa theprerequisite forgrowth. According tohim,constant been stirred up. Americanpsychotherapist Will Davis (1990)seesinthetransitionsfrom form. This iswell illustratedinthefamousimageofaglasswaterwhichsandhas Neurobiological learningresearch muchthatbodypsychotherapists supports already The functionalapproach ofbodypsychotherapy withitsemphasisonthequestion“How Here, bodypsychotherapy meets research ontransitionalphenomenafrom the field Conclusion SENSE ANDSENSIBILITY 13 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 14 International Body Psychotherapy Journal The Art and Science of Somatic Praxis Schule. (2006).Leseprobe. Das Eltern. Magazin fürengagierte In G.Schiepek(Ed.), Neurobiologie derPsychotherapie. Stuttgart. Ordnungsübergänge -eine Verbindung von Tradition undaktuellerForschung inderPhysiologie Schmidt-Schönbein, H.,Perlitz, V., &Schiepek,G.(2003).Das Paradigma antriebsabhängiger Neumann-Wirsig (Eds.), SupervisionintelligenterSysteme Aachen. Levold, T. (2004).Affektive Kommunikation undsystemische Teamsupervision In H.Kersting &H. Reichianische Körperarbeit, 5,64-98. Knapp-Diedrichs, V. (1992).Grundlagen energetischer Atemdiagnostik. Ströme Rundbrief In H.Neumann-Wirsig &H.Kersting (Eds.), SupervisioninderPostmoderne (pp. 133-140). Lambelet, H.(1998).Grundsätzliches Vorgehen Körperinterventionen. inderBeratung mitintegrierten Kistler, P. LernenunterStrom. (2004,1204).[Interview]. Badische Zeitung. Unpublished mastersthesis foramastersdegree Freiburg. insupervision. Huerta Krefft, S.(2006).“Checktheflow”- körperkommunikative inderSupervision. Aspekte Grawe, K.,&Donati, R.(1994/1995).Psychotherapieim Wandel. Göttingen. undPsychotherapie. (pp. 219-256).Hannover. Integrierte Medizin. In S.Gunkel (Eds.), Integrierte &G.Kruse Medizin Salutogenese, Resilienz Geigges, W. (n.d.).Auf derSuche nachderverlorenen Kunst desHeilens -Psychosomatik als Fatzer, G.,&Scharmer, Ein Prozess, C.O.(2005/2006).Führungslaboratorium: drei (sic)Räume. Fallne, H.,&Pohl, M.(2001).CoachingmitSystem. Wiesbaden. Davis, W. (1991).Points andCharacter, andpositions.Energy 97-109. Davis, W. conceptsinmodern (1990). andReichian energy The interdependency ofhumanisticpsychology Damasio, A.R.(2003).LookingforSpinoza: Joy, sorrow, andthefeelingbrain. New York: Harcourt Inc. SchwäbischGmünd. demHintergrund humanistischenPsychologie. derkörperorientierten Inaugural Dissertation. Bulling, H.(1999). DieEntwicklung fürdieArbeit einesSupervisionskonzeptes mitLehrerinnen auf Boadella ,D.(1991).Organismus undOrganisation. Energie undCharakter Sonderband,1-59. Bauer, J.(2005).Warum ichfühle,wasdufühlst.Hamburg. Bauer, J.(2002).Das Gedächtnis desKörpers.Frankfurt amMain. REFERENCES SIBYLLE HUERTA KREFFMA,ECP Seminar papers.Master curriculuminSupervisionLutherian University-Freiburg, 8. physics. Sinsans. 35-50.

© Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 12,Number 1,2013pp15-26Printing ISSNNumber 2169-4745Online ISSN2168-1279 International BodyPsychotherapy Journal TheArt andScienceofSomaticPraxis part ofthedata(McCracken,part 1998;Pidgeon &Henwood, were 1997).Interviews recorded approach, inwhich theauthor’sgrounded theory assessmentsandimpressions are anintrinsic Procedures to integratetheirwork. reconcile them? willexploreThis article how dually trainedcliniciansintegrateordecidenot 2001; Miller, 2000; Ogden, 1997;Ross, 2000).How dotherapiststrainedinbothmodels two practices,unabletostraddlethisprofessional andculturaldivide(Greene, 2001;Hadar, pursue traininginbothpsychodynamic andbody-centered therapyoftenfindthemselves with associated with“borderline” and“primitive” states(Miller, 2000).Accordingly, clinicianswho Gales, 2000),butstillfavors verbal expression bodilyexpressions andviews as“acting out” psychoanalysis makescentralthepatient’s experientiallyfeltsenseofself(Shane, Shane & Siegel, 2001; Siegel & Solomon, 2003; van der Kolk, 1996; van der Kolk 2002). Contemporary experience, are centraltohealing(Ford, 2002;Porges, 2011;Schore, 1994; Schore, 2003; that demonstrateswhatbody-centered thatthebody, therapyhaslongasserted: andbodily by agrowing body of neurological and biological research in the area (particularly oftrauma), body-centered therapiesare now increasingly popular(Shannon, 2002),andare supported experience (Caldwell, 1997;Pruzinsky, 1990;Smith, 1985).Once relegated tothemargins, with theformertraditionallyprivilegingwords and“insight” andthelatter, sensationand about touchare alsobriefedaddressed. andpsychoeducationinterventions, ofpatientsregarding integratedwork. Concerns transference/countertransference, conceptualizationofpatientexperience,technical psychodynamic framework.Differences andsimilaritiesare discussedwithregard to made useofassimilative integration,incorporatingbody-centered techniquesintoa allofwhomintegratedtheirworkwere tosomedegree. interviewed, The majority the twotheoretical traditionsintheirclinicalwork. Eleven duallytrainedclinicians psychodynamic andbody-centered therapiesintegrate,orchoosenotto studyexaminingthewaysinwhichpsychotherapists trainedinAn exploratory The author developed and administered a structured interview to participants usingthe toparticipants The authordeveloped andadministered astructured interview Psychodynamic andbody-centered from therapieshave eachother historicallystoodapart Submitted 30October 2012;received inrevised form8March 2013;acceptedMarch 2013 Key words: psychotherapy integration,psychodynamic psychotherapy, body-centered therapy Bridging theSplit:IntegratingPsychodynamic and Body-Centered Therapies Claire Haiman,PsyD Methodology Abstract BRIDGING THESPLIT 15 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 16 International Body Psychotherapy Journal The Art and Science of Somatic Praxis experiencing somatic countertransference. patient as“hunches” or“intuition,” ratherthanas“countertransference”. They did notreport therapist about what the patient needed. These clinicians described their reactions to the that are interpreted astransference in psychodynamic work asdirect communicationstothe relationship asacentralvehicle ofhealing.Instead, theyunderstoodthose patientresponses according tothese“converts”, theskillsprovided by BCTobviated theneedtodevelop the by pointingoutits ubiquity as“an ever-present phenomenon” life.Furthermore, ineveryday of anentirely BCTpractice. oftransferenceThese cliniciansde-emphasized the importance maintained twoseparatepractices—oneBCTandonePDP. fromhad essentiallyconverted PDPtoBCT, thosewhosynthesized them,andthosewho in different waysintheirrespective practices. Three distinctgroups emerged:thosewho Integrating Psychodynamic andBody-Centered Therapies disorders andthelike. theoretical compasstheyneededtorecognize andnegotiatecomplicatedself-states,personality contain theexperience. inthestudyoftenspokeofPDPasprovidingThe participants the deepplacesbutthetherapistwasnotabletoprocesspatients where or theygotintovery or personality disorders.” This had asBCT corroborated some of the experiences participants compass so they don’t do work with patients who are too fragile or fail to recognize the splits “Aof oneparticipant, lotof[therapists]are guidedby goodintuitionbutneedmore ofa came upinsessionthatdidn’t matchthetechnicalguidelinesofBCTmodel. In thewords sufficient theoretical underpinning. They feeling confusedandadriftwhensomething reported that thebodywasessentialtogoal. clinical practices. Further theyhadanintuitive senseofneeding and wantingtogo deeper and this lesserefficacyandefficiencyintheir ownpersonaltherapiesas wellasintheir respective preverbaldepth inparticular placesthatare difficultto reach intalktherapy. Most experienced hierarchical, andineffective or(atbest)effective butslow andinefficientat reaching psychological psychotherapy (PDP)andcametofindit overly intellectualized and(atworst)withholding, Critiques ofPsychodynamic andBody-Centered Therapies Sensorimotor Psychotherapy, andSomatic Experiencing. Hakomi Method, Pesso Boyden System Psychomotor Therapy, Rubenfeld Synergy Method, centered trainingincludedBioenergetics, Core Energetics, Craniosacral Therapy, EMDR,the psychodynamically oriented programs. Four had also obtained psychoanalytic training. Body- both psychodynamic andbody-centered therapies.Allhadreceived MSWorPhD degrees from Participants Strauss andCorbin(1990). against relevant literature inthefieldtoidentifycommonthemes,methoddescribed by wereand transcribed.Individual thencompared interviews withoneanotherandconsidered CLAIRE HAIMAN,PsyD Three fellintothefirstcategory, participants thatofthosewhohad rejected PDPinfavor After receiving traininginbothPDPandBCT, combinedthesemodalities participants Two beganwithtraininginBCTandfoundittechnicallyeffective butwithout participants Nine of theeleven respondents had begun theirtraining and practice inpsychodynamic wereThe participants eleven cliniciansintheNew York Cityarea whohadbeentrainedin Results Dan Siegel. She “panicky”. describedworking withapatient whowasvery Winnicott indescribingtheir theoretical mentioned AllanSchore stance,thisparticipant and Experiencing] are abouttoleratingandexpandingaffect.” Whereas otherclinicians tendedtocite system arousal andaffect regulation. In herwords, “both [psychodynamic therapyandSomatic attachment orbodyposture, shewasconceptualizingpatientexperienceintermsofnervous base modelandassimilatedPDPBCTtechniquestheories. Whether shewasconsidering reported aninstanceduringwhich their own bodilyreactions asrelevant to theclinicalencounter. For example,oneclinician touch. These cliniciansmadeuseofsomaticcountertransference, listeningforandinterpreting reported that transference was intensified in BCT, which they attributed to therapist-patient doesitfeellikewhenItouchyou here?’ or‘Howit...‘What doyou feelaboutme?’” They also countertransference in“exactly thesamewayasinpsychodynamic work. You talkabout and appliedPDPconceptstobodilyexperience.For example,oneclinicianconceptualized In thisinstancecliniciansincorporatedBCTtechniquesintothetheoretical framework ofPDP intoanotherhome-basemodel and translatedusingthelatter’simported theoretical framework. “assimilative integration” (Messer, 1992; Wachtel, 1991)where thetechniquesofonemodel are and you’re doesthisremind you of?’” notlike,‘What rage comingupthrough therightarm’ and you nameitandholdaspaceforhelpclear to the“verbal skills” ofcraniosacralwork whichwas“much more about‘There’s abigwave of that shewouldrefrain from goingintotransference “as deeply”. Instead sheimaginedadhering came up” inthepriorcraniosacralsession—allwithsamepatient. This clinicianalsoanticipated sit andtalk”, acraniosacralsessiononthetable,andwhere “we’d talkandprocess what this changeasallowing foratreatment where shecouldshiftbetween aPDPsession“where we of herintentiontomove toward amore integrative referrals. practicewithnew She envisioned destabilizing tothetherapist-patientrelationship. One ofthesetwoclinicians,however, spoke to traditionalnotionsoftransference andcountertransference. They understoodtouchas them separateinpractice.Bothconceptualized theirwork aspsychodynamic andsubscribed to myselfwas,“She needstobring herarousal down.” What Istillbelieve is thatI,asthe “Try to relax, feelyour body, whatcomesupinyour body.” In mymind whatIwassaying using theattachmentrelationship—that wasthepsychodynamic piece—butsomeofitwas, to bring the A arousallot of the work down, was around trying some through eye contact, interestedOne ofthesixparticipants insynthesizingusedaffectregulation asherhome- Ishurts. there somethinggoingonwithyour rightshoulder?” I tenseabout?” When I’m really tunedinwithsomeone...Iwouldsay, “My rightshoulder countertransference reaction. isthispersonmakingmeafraid? Iaskmyself,What am “Why My stomachisinknots.I’m noticingthatI’m notbreathing. To methatcouldbea Participants interested insynthesizingtendedtowork withtransference and holding, thisisanotherstepalongthatline. ofholdingenvironment,do believe like thatthisisasort Winnicott’s idea,thatthisisliterally those internalized selfimages...[My work is]onacontinuum[withpsychoanalytic work.]...I It’s alllinked...It’s justthatyou usethebodytobeginexpress someofthe andarticulate that, thatthefirstegoisabodyego. It’s thebeginningofway we understandourselves. how theywere nurtured orcared for, how theyformedtheiregostructure. Freud talksabout People will have of their bodies that really notions or feelings about their bodies or parts reflect looking atthedialogueswithdifferent of your bodyby parts thinkingofthemasself-objects.... Six attempted to integrate both methods in their clinical work. of the participants Five used Of there theeleven participants, were twowhoembracedbothmodalitiesbutkept BRIDGING THESPLIT 17 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 18 International Body Psychotherapy Journal The Art and Science of Somatic Praxis CLAIRE HAIMAN,PsyD on hisbody, she don’t feelanything. Iwantyou to stop askingme.”Even thoughshestopped explicitfocus saying “Every timeyou ask me aboutwhatIfeelinmybody, it’s really annoying tome,I with whathe’s feelingandthinksalot”. She hadsuggested usingBCTbutherejected it, patient who“would probably beconsidered outoftouch alexythymic and isreally very two separatepractices)adoptedthesamephysicalposture inbothPDPandcraniosacralsessions: initself.to thepatients,asapowerful intervention For example, oneclinician(whomaintained isatthemoment. truth You cangive themawayinto themselves by lookingatthebody.” up,not sayingmuch,buthisorherbodyiscrumpled that’s what’s happening,that’s where the curiosity aboutwhyfeelingsare inaccessible.In thewords ofanotherclinician, if“someone’s Participants likethisasdeepeningemotionalexperienceorprompting a sawinterventions said thateven in“straight talktherapy”, shewill: the bodywith a keener eye. For example, one clinician who attempted to synthesize herwork supported. Then lifeshifts. They needtoknow what safetywouldhave feltlike.” [patients] were inchildhood,they needtoknow totallyunsupported what itfeelliketobe that“if impediment toit.Onecommonamongparticipants cliniciansummeduptheview around. Alongtheselines,gratificationwasseenasessentialtothework, ratherthanapossible experience over putit,“Insight insight.Asoneparticipant follows healing,”nottheotherway as facilitatingthepatient’s “natural healingprocess” ofinvivo andemphasized theimportance centrality oftraumainthedevelopment ofpsychopathology. They conceptualized theirwork Commonalities AmongAllParticipants remained steady. This clinicianreflected thatthisshiftwas “keep lookingatme”, ratherthanlettingthepatient’s gaze wanderwhilethetherapist’s gaze This eye contactdiffered to from thatoftraditionalPDPinthepatientwasinstructed Another clinician who also sought to synthesize these two modalities reported about a I don’t sayanythingtothepatient butI’m justshiftingtheresonance intheroom. disorganized I’ll goingmidlinetoandit’s start amazinghow itorganizes thefield. Mostly more receptive space.Especiallyinananalytic sessionwhere thingsare gettingtightand I really ground inmymidlineandholdaswideaperceptual fieldasIcanso[I’m] inamuch Several cliniciansreported thatadjustingtheirphysicalstance,withoutindicatinganything and I’ll say, “Do thatalittlemore. Really furrow thatbrow. What doesthatfeellike?” Can you checkinwiththat? What doesthatpositionfeellike?”Or they’ll furrow theirbrow into thehere and now with the body. “Inoticeyour arms are covering your abdomenthere. just keepwatchingtheirbody, theirbreathing. Instead ofjusttalkingaboutstuff, I’ll bringit Even didnotintegrateexplicittechniquesfrom BCT, ifparticipants allreported observing Regardless of whether they integrated their work agreed or not, all participants on the to holdpeopleinaspace. helpful withthatandIthinkbodywork hasalottoofferthere. Ithinkit’s really important That’s withpsychodynamic true work too. Information aboutthebrainhasbeenreally old defenses.Unless they’re place,theywillgobacktotheiroldpatterns. heldinacertain be directive withoutitbeingintrusive...People lefttotheirown deviceswillgobacktotheir the biggestdevelopment forme.Other thanlearningsomatictechniques,theideathatIcan physical—it’s asomaticintervention. you’re sayingitreally istherelationship andthecontact[that’s healing],butthenit’s very me in that way. I’d psychodynamic use a lot of eye contact, which is very in a way because attachment figure, wasthe personwho wasgoingto helpher regulate andthen she’d see around establishingasecure attachment. preoccupied attachmentstyle.”For months oftreatment thefirst few thefocus was eye contactinworking withapatientwhowas“hyper-aroused, panicky, witha or cooling depending on context. For example, one clinician described her use of their practice,mostnoted that atechniquecouldbeexperiencedaseitherheating containing/cooling andactivating/heating were essentialandbasictechniques of activating technique: Another cliniciandescribed“the handonthebackexperiment” asanexampleof working withissuesof“closeness anddistance” asanactivation techniqueby feeling andintensifypatient’s ofthisstudydescribed contactwithfeeling.One participant there. boundary have patientsholdthemselves, ortouchtheirown skintobecomeaware ofthephysical or reality-testing was poor. This did not mean there was no contact. Rather, clinicians might cautiously,patient touch,orapproached itvery whenthepatient’s boundarieswere diffuse ground? Canyou feelmetouchingyou?” Most however, participants, eschewedtherapist- He wouldputhishandonsomeone’s armandask,“Canyou hearmetalk?Canyou feelthe between you andme” ofbeing“really anotherclinicianemphasized theimportance concrete”. female patientwhere awareness described her useofa containing techniquewith a techniques.One participant such asfeelingtheweight ofthebodyinchair, creation/boundary andboundary as “cooling”) includedrelaxation techniquessuchasdeepbreathing, “grounding” techniques intense experienceandevoking intenseexperience.Containingtechniques(alsoreferred to integrated PDPwithBCTidentifiedtwocentraltechnicalintentions:containing Synthesizing Techniques: Containingvs.Activating Although allclinicianswho triedtosynthesize these modalitiesagreed that of beinghitintheback”, shesaid. as Imoved toward herback.Icalledattentiontoit.“I’m togetmemoriesnow starting sure. “I’ll withandthenwe’ll putitinthemiddletostart move itaround.” Isawherflinch my hand on your spine that would feel OK?” It’s a mindful experiment. This woman wasn’t I say, “Be intouchwithyour spine.Become aware ofit.Is there anyplacewhere Icouldput feel likewhentheconnectionistooclose? Where dotheyfeelitintheirbody? then anotherstepforward. Then we’ll whatit’s try liketocomereally close. What doesit they’ll say, “No. I’ve losttheconnectionnow.” Iwantyou And tocomeonestep forward. them abouthow thedistancefeels,whatconnectionfeelslike.I’ll back,then gofurther closetothem[theclients]andhave themtellmewherestarting tomove andcheckwith Activating techniques(alsoreferred toas“heating” techniques)are designedtoarouse Similarly, whenworking withsomeonewho“needs structure-building totellthedifference that shehassomecontrol over it...[andthat]we canwork withchoosingtoexpress it. and] holditandlethersensetheaggression inherselfandseehow herbodycanholditand relationships, ofafraid ofit.Ihadhermove but...shewasalsosort intohittingandthen[pause the angerwasburstingoutallover theplaceandgettinginwayofherinterpersonal In additiontoemphasizingbodilyfocusandawareness, whoactively participants didn’t wantit. body. So Ifeltlikewasstilldoingsomaticwork even thoughhewassoinsistentthat tone ofvoice tohissoIbecamereally toregulate aware his ofhisbodysignalsandtrying careful touseallhisnonverbalwas very cues—I’d mimichisbodygestures orI’d attunemy BRIDGING THESPLIT 19 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 20 International Body Psychotherapy Journal The Art and Science of Somatic Praxis CLAIRE HAIMAN,PsyD pattern intheir body?’” checking, ‘Am I pulling away or am I having not to to exertget pulled into a a lot of effort reported, “I’m As oneparticipant somatic countertransference) in choosingtheirinterventions. activating techniques. mind’s eye onyour body?”Afterestablishingthisbaseline, theclinicianwasabletousemore focus oninternalsensation,prompting withcueslike“as you talk, isitpossibletoputyour intellectual way”. Starting with relaxation and deep breathing, this therapist had the patient who “would beconsidered avoidant…over-regulating, hypo-aroused, talkinginacut-off containment toaccesssomeoftheactivation. This cliniciandescribedherwork withapatient when actuallytheyare soover-aroused thattheyare inafreeze response, andthusinneedof patients cancomeacross asintellectualized andcutoff(i.e.,inneedofanactivating technique) were alexythymic,obsessive, schizoid, orhadAspergers. anal stage”, by another. Clinicianscitedsuccessusingactivating techniqueswithpeoplewho emotions. This statewasdescribedasoneof“hypo-arousal” by oneclinician,and“beinginthe individuals, thoseorganized attheneurotic level andthosetendingtobedisconnectedfrom stages)—in otherwords, statesofhyper-arousal. In thewords ofoneparticipant, appropriate in working with people in psychotic, borderline, dissociative and oral states (or whether tousecontainingoractivating techniques.Containingtechniqueswere deemedmost history, fearsoflitigation,andpatientexpectationstreatment. These factorswere: theresults ofthepsychodynamic assessment,existenceofatraumaorabuse and technique they drew frominfluenced the modality (PDP or BCT) in the clinical encounter. Their Work Who Gets What?: Factors Determining Practice Among Therapists Seeking to Synthesize clearly usedtoevoke powerful feelings. therapist-patient touch could be experienced as containing or soothing, and others where it was touch was“heating”, leadingtoanintensifiedtransference, there were someinstanceswhere context-specific intervention. While there was general agreement that among participants development of the therapist-patient bond. Therapist-patient touch was seen as a similarly Here, eye contactshiftedfrom beinganactivating toacontainingtechniquethrough the As mentioned previously, relied participants heavilyontheir countertransference (including who synthesizedOne herwork participant addressed atrickyparadox: sometimesa Participants reported that activating techniques were well suited tooverly bounded something withthosefeelingsratherthangetthemmore ampedup. contact withdepthsoffeelingstheydon’t know whattodo with. I’m justhelpingthemdo much. Iwouldjustwork physicallywithwhattheyare already feeling. They already have raise theirenergyoremotionallevel. That’s whatyou dowithpeoplewhoaren’t experiencing I’d careful [working very withsomeonewhowaspsychotic]. to bevery Iwouldnever try Psychodynamic assessment. Cliniciansoftenrelied onPDPassessmenttodetermine For whodidblendtheirwork, there participants were several significantfactorsthat more activating issues]. phase where she’d wasalright[assheexplored lookbacktomeandmakesure everything resource shewouldlookatmeanditfeltlikethepracticing sowhenshewasuncomfortable I wasactuallyfeeling.Fortunately Ireally likedheralot. Then [theeye contact] became a She’d say, is too much for you. “This You don’t like me anymore.” I was able to tell her what We comesupforyou asyou’re spentalotoftimeineye contact.“What lookingatme?” sought herout for PDPandexplicitlystated: whosynthesized thesemodalitiesreportedparticipant working withapatientwhospecifically was more appropriate, theyvaried inhow theywent aboutintroducing theconcept. One what theyexpected.In instances where cliniciansfeltanothermodalityorablendedapproach another approach, one thatwasmore body-focusedand experiential.By andlarge,patientsgot a significant,butever-growing number(usually veterans oflong-termPDP)arrived seeking some seekingBCTasanadjunctive therapy orforthetreatment ofaspecific trauma,and deciding whototouchandhow theywouldtouch. ability toaccuratelyread ofcountertransference, in patients,emphasizingtheimportance ofthing.”Allrelied laxaboutthatsort ontheirmight arise,butmostreported “beingvery toheadoffanyfuturethat thework wouldincludetouch,inaneffort problems that appropriate forthetherapisttotouchthem.Some obtainedexplicit informedconsent (e.g., wrappingthemselves tightlyinablanket to provide containment)whenitwasnot Others figured outwayspatientscould approximate theexperienceofbeingtouched a group where touch happened with other members within the Psychomotor Structure. regard totouchbecauseoffearslitigation. One clinicianroutinely referred patientsto child. Some ofthetreatment was To describedworking withawomanwho’d thisend,oneparticipant beensexuallyabusedasa that, whenitcomestotouch,patients“call theshots...theyare incontrol. That’s aground rule.” using therapist-patienttouch.One clinician captured thesentiment common toallparticipants spoke oftheneedtomove slowly andwiththepatient’s explicitpermissionandguidancewhen forcompleteresolution ofthetrauma.Allparticipants tended tofeelthattouchwasnecessary experiencedtouchasthreatening anddangerous. feltthatsurvivors However,participant they to usetouchinintegratedbody-centered ofsexualabuse.Allbutone work withsurvivors previous abuse: to BCTreported working inagroup Psychomotor structure withapatientwhowasrevisiting and ambivalent feelingsabouttouchandintimacy. For example,oneclinicianwho“converted” abuse, clinicians made use of a variety ruptures of containing techniques to address boundary Patient expectation.Some patientsarrived attreatment specificallyseekingPDP, Fear oflitigation.Most reported thattheymodified theirwork participants with had control over. away.” She hadcontrol over it. There wouldbetouchthatcouldsafeorokshe say, “Ok. Iwantyou toputyour handhere [onherstomach].AndIwantyou totakeit touch. The patientcandothisherself, andthenI’d benexttoher. At somepointshe’d working withherinexercises thatinvolve pelvicmovement. withThis isnotparticularly abouthow views These clinicianstendedtohave multipleandseeminglycontradictory the faceofabuse. rechanneled soit’s okaytoopenupforanappropriate partner. It’s alimitonopeningin the energy. “It’s oktohave allthatenergy. Iwon’t letyou openforabuse.”It helpsitget strong toholdtheirlegstogether,someone very andatthesametime,benign:accepting by holdingtheirlegstogether. hard very toopen. very You patient]cantry [The need it. A“limitfigure” isthenenlistedtocontainthepatient’s desire to reenact theabuse, happened so the pilot [a witness figure in Psychomotor] can see it and they can work with leaning toward [theabusingfather]…Thathastobestopped.So Itellthemwhatjust You seetherageon[thepatient’s] buttheirlegsare faceandhurt, openingandthey’re Trauma/Abuse history. In working withpeoplewhohadunresolved traumafrom prior BRIDGING THESPLIT 21 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 22 International Body Psychotherapy Journal The Art and Science of Somatic Praxis CLAIRE HAIMAN,PsyD her Rubenfeld Synergy Work) assembledinheroffice, knowing thatshewas, example, whenshewasseeingsomeonereferred for PDP, shelefthermassagetable (usedin left cluesaround theofficeandfigured thatifpeople were interested theywouldinquire. For it’s notamagicbullet butitdoesallow ustogofaster.“ aboutwalkinginthe park andhow“her story bilateralstimulationmakesadifference… more effective thanjusttalktherapy.” Then shesaidwouldintroduce Shapiro and introduce EMDRsaying:“For thepastfive years I’ve beenusingatoolthatIfindfar seeking. For example,oneclinician afterdoingafulltrauma-sensitive intake,would issue directly from theoutsetoftreatment, regardless ofwhattherapythepatientwas from(both ofwhomhadconverted aPDPtoBCTpractice)addressed themodality inwhichthecliniciandisclosedtheirapproach.out process ofsorts Two participants therapist usedsomeBCTtechniques,mostlyfocusedonbreathing andbodilyawareness, who soughtheroutforBCTbecauseshe“hadalotofdifficultyexperiencingfeelings.” The ofPDPtreatment This sameclinicianreported working withanotherpatient withalonghistory of treatment shewouldtell patients, tolay agentlefoundationbecauseIthinkpeoplecanfinditbit odd.” At theoutset[BCT] clinician left it “somewhat vague. I’m careful when people don’t very have a background in work with more tofollow as it emerged in the treatment. In describing herapproach, one Another participant tooktheotherextremeAnother participant andsaidnothingatall.Instead, thisclinician In instanceswhere patientswere notaware ofthedifferent modalities,there wasacoming- physical work again,now withmore trust. or sheneededtoreally someofthe experiencemecaringabouther….Maybe Iwouldtry psychodynamically. It tooktwoto three years. Her issuewasbasicallyinterpersonaltrust todothatwithherandworked withher ultimately happenedwasIstoppedtrying ofspacedout...Ithinksheprobably dissociated.Itand shejustsort wasn’t helpful. What ofway.sort skull. It allowed andtofeelthingssheneededfeel. We hertocry went oninanintegrated she wouldn’t letherselffeel.It wasreally simple.Ijustputsomepressure atthebaseofher whatever itis”...Thetry headachewoulddevelop around thingsthatwere comingupthat She saidshe’d thinkaboutit. The nexttimeshecame back andithappened she said,“OK, that butI’m sittinghere withalotofambivalence becauseIthinkthiscouldbehelpful.” said clearlyatthebeginningthatyou didnotwanttodealwiththis.I’m really respecting a headacheinthemiddleofsessionsoIsaid,“Look,canhelpyou withthis,butyou togetheadachesfrequentlyshe started duringhersessions...Finally onedayshewasgetting therapist. Don’t bothermewiththisotherstuff.” So Isaid,“Fine.” We towork and started “I don’t wantanyofthisbodyenergystuff. I’m here becauseIheard you’re areally good Sometimes I might ask you what’s happening in your body, in other words, what sensations Most however, participants, provided patientswithagentleintroduction totheirblended might seemySynergy onthewallandtheymightaskaboutit. certificate usually an indicationof them edging toward being more interested in it. Other patients that’s sexuallyabusednever asked meaboutthetable…Theircuriosityis very beenvery doyou doonthattable?”So“What that’s thewaythatwe start. They askme. The one asked me,“So whatdoyou dowiththetable?” This in-her-headwomancameinandsaid, of them this work could be an adjunct to what I do. So I’ve kept it up and people have up because I wanted them to know who I am and what I do and also I think with each introducing something. With allof[mypatients]Imadethedecisiontokeeptable seemed, unwittingly, psychoanalysis. tomirror developments inthefieldof contemporary a more experientialprocess. of patientswhowere veterans from PDPseekingBCTorblendedPDP-BCT tofacilitate became relevant inthetreatment. Of note,several cliniciansdescribedagrowing number vaguely at theoutsetoftreatmenteither gentlyandsomewhat ormore explicitlyasit more orlessreceived it,thoughclinicians oftenintroduced theirblendedapproach, were alsoguidedby patient’s expectationssothatpatientsseekingeither PDPorBCT technique and or even inonephaseoftreatment, andthencontaininginanother. Method were context-specificsosomething,likeeye-contact, couldbeactivating inonetreatment, arousal, intellectualization,obsessionality, However, orcompartmentalization. alltechniques dissociation, psychosis andthelike.Heating/activating techniques were best-suited forhypo- the room. Cooling/containingtechniqueswere deemedmostappropriate forhyper-arousal, simply focusedonhis/herown tochange thelevel ofactivation bodilystateinaneffort in overt, covert,the very incorporatingtherapist-patienttouch,tothevery inwhichthetherapist hypo- orhyper-arousal. a widerrangeoffeelings(bothemotionsandsensations)withoutlapsingintostates the bodysotheycouldrevert toaphysiologicalbaselinethatallowed forexperiencing healing. Asuccessfultreatment, in essence,allowed patientstoprocess traumaheldin clinicians emphasized thecentralityofsensationandbodilyexperienceinpathology and perhaps, tosaytheywere strivingfora corrective physiological experience, asthese emotional experience” asfirstdescribedby Alexander(1961).It wouldbemore accurate, theneedtobesafe)andgratifyingthem,soascreateneeds (particularly a“corrective as central to psychopathology, and used a treatment approach of identifying unmet of how theyconceptualized theirstance,allthecliniciansinthissamplesawtrauma were “converts” whohadleftPDPbehindandpracticedBCTexclusively. Regardless practices—one devoted to PDP and another devoted to BCT—and three clinicians integrate PDPandBCTintheirclinicalwork. Two cliniciansmaintaineddistinct actively soughtto abouthalf(sixparticipants) and body-centered therapies(BCT), Another clinicianintroduced body-centered work isinthebody by tellingpatientsthatthetruth The critique of psychodynamic theory andpractice whichemergedamong participantsThe critiqueofpsychodynamic theory While bodily experience was central to all treatments, specific interventions rangedfromWhile bodilyexperiencewascentraltoalltreatments, specificinterventions Of whohadsoughttraininginbothpsychodynamic theeleven participants (PDP) might notbeconsciousandyour bodymighthave thisinformation. there—we maylearnsomethingaboutyourself becausethere’s apieceofyour beingthat help you tuneintoyour body—becauseit’s notlikeI’m andyou’re theexpert justsitting forunconsciousemotion.If youand thebodyisarepository tuneintoyour body, andI necessarily [have] whenyou’re justthinkingaboutwhatyou’re feeling. there are sometimesthingsyou have accesstoasyou focus onyour bodythatyou don’t body intermsofthoughts,images,becauseIfindthatithelpsmove thework alongand are you feelinginyour body, orI’ll askyou toassociatesensationsyou’re havinginyour Discussion Conclusion BRIDGING THESPLIT 23 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 24 International Body Psychotherapy Journal The Art and Science of Somatic Praxis Breckenridge, K.(2000).Physical touch inpsychoanalysis: Aclosetphenomenon? Psychoanalytic Bar-Levav, R(1998).Arationalefor physicaltouchinpsychotherapy. In E.Smith, P. Clance,&S. Aron, L.(1996).Ameetingofminds:Mutuality inpsychoanalysis. Hillsdale, NJ:AnalyticPress, 1996. Arkowitz, H.(1997).Integrative theoriesoftherapy. In P. Wachtel &S.Messer (Eds.), Theoriesof Alexander, F. (1961).Thescopeofpsychoanalysis. New York: Basic Books. REFERENCES Email: [email protected] practice inNew York City. She hasalsocompletedKathyKain’s Touch Skills Training for Trauma. Claire isinprivate Claire Haiman, PsyD isaclinicalpsychologist andSomatic Experiencing Practitioner. BIOGRAPHY founder oftheHakomi Method, Ron Kurtz. as well asContinuumMovement founder, Emilie Conrad,andtherecently deceased Institute includespsychoanalysts Phillip Bromberg, Martha Stark, andBeatrice Beebe, body andpsycho-therapies. Similarly, theBoard of theSensorimotor Psychotherapy Psychotherapy Journal now ofinstitutionalized dialoguebetween mayheraldasimilarsort the USABodyPsychotherapy Journal in2002andtheadvent oftheInternational Body (SEPI) andtheJournal forPsychotherapy Integration (Arkowitz, 1997). The creation of this blending,suchastheSociety fortheExploration ofPsychotherapy Integration behavior therapiesultimatelyledtotheestablishmentofformalstructures celebrating BCT work thatfelttoofreeform andunmoored. The integrationofpsychodynamic and andmethodologytogroundthat felttoointellectualized andmakinguseofPDPtheory Similarly, utilizingBCTmethodstobalance outPDP inthissamplewe seeparticipants (Arkowitz,incorporated cognitive models of understanding and intervention 1997). coping mechanisms and the impact of external experience; behavior therapy increasingly toward thecenterfrom bothcamps.Psychodynamic work increasingly addressed patients’ and behaviortherapies.In thatinstance,aninitialantagonismgave waytoamovement is perhapsfollowing apatternsimilartotheintegrationthatoccurred between PDP integrating theseapproaches. systemarousal, themore andeasetheyhadand modelsofautonomicnervous comfort developments. Conversely, themore aboutattachmenttheory thesecliniciansknew in theirdenunciationofpsychoanalysis alsotendedtobemostoutoftouchwiththese in thepsychoanalytic world.Indeed, cliniciansinmysamplewhowere most vehement the psychodynamic unaware communitymayhave madeparticipants oftheseadvances 2001; Stolorow & Atwood as cited in Biurski & Haglund, 2001). Moving away from fact the cornerstones of intersubjective psychoanalysis (Aron, 1996; Biurski & Haglund, unconscious, andthat feeling, rather than insight,wasthemotor of treatment are in to thetherapistaboutwhatwasneeded, rather thanaveiled communication from the therapist andpatient,thattransference wasanexplicit communicationfrom thepatient These notions—thatthepatient’s experiencewasreal, aswastherelationship between CLAIRE HAIMAN,PsyD It seemsthatthe integrationbetween psychodynamic andbody-centered therapies Imes Association. Psychotherapy: Origins andEvolution (pp. 227-272). Washington DC:AmericanPsychological (Eds.), Touch inPsychotherapy (pp. 52-58). New York: Guilford Press. Schore, A.(1994). Affect regulation andtheoriginofself: ofemotional The neurobiology Schlesinger, H.&Appelbaum, A.(2000). When words are notenough.Psychoanalytic Inquiry, 20, Ruderman, E.(2000).Intimate communications: The value andboundaries oftouchinthe Ross, M.(2000).Bodytalk:Somatic countertransference. Psychodynamic Counseling,6,451-467. Pruzinsky, T. (1990).Somatic approaches topsychotherapy andpersonalgrowth. In T. Cash& T. Porges, Neurophysiological S(2011). Thepolyvagal theory: foundationsofemotions,attachment, Pidgeon, N.&Henwood, K.(1997).Using inpsychological grounded research. theory In N.Hayes Miller, J.(2000). The fearofthebody inpsychotherapy. Psychodynamic Counseling,6,437-450. In J.Norcross &M.Goldfried (Eds.), Handbook ofPsychotherapy Integration (pp. 130-168).New Messer, S.(1992).Acriticalexaminationofbelief structures inintegrative andeclecticpsychotherapy. 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Inquiry, 20,21-43. Boston,MA. therapeutic interventions, Paper presented attheannualconference, Psychological Trauma: Maturational processes and Counseling, 7,41-62. Wheaton, IL:Quest Books. Inquiry, 20,2-20. Doing Qualitative Analysis (pp. inPsychology 53-79).Erlbaum, U.K.:Psychology Press. Touch inPsychotherapy (pp. 201-219).New York: Guilford Press. Psychoanalytic Inquiry, 20,108-123. BRIDGING THESPLIT

25 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 26 International Body Psychotherapy Journal The Art and Science of Somatic Praxis Westen, D.(2000).Integrative psychotherapy: Integrating psychodynamic andcognitive behavioral Wachtel P. (1991). From eclecticismtosynthesis: Toward amore seamlesspsychotherapeutic van derKolk, B.(2002,September 14).Thebodykeepsthescore: Integration ofbodyandmindinthe van derKolk, B.(1996). The bodykeepsthescore: Approaches tothepsychobiology ofpost- Strauss, A.&Corbin,J.(1990).Basics ofqualitative research: Grounded procedures theory and Smith, E.(1998). Traditions oftouchinpsychotherapy. In E.Smith, P. Clance,&S.Imes (Eds.), Smith, E.(1985).Thebodyinpsychotherapy. Jefferson, NC:McFarland &Co., Inc. Siegel, D&Solomon, M.(2003).Healing Trauma: Attachment, mind,body, andbrain.New York: Siegel, D.(2001). The Developing Mind: How Relationships andtheBrain Interact toShape Who Shannon, S.(2002). The emergingparadigm.In S.ShannonandAlternative (Ed.), Complementary Shane, M.,Shane, E.,&Gales, M.(2000).Psychoanalysis unbound:Acontextualconsiderationof Schore, A.(2003).Affectregulation andtherepair oftheself.New York: Norton. CLAIRE HAIMAN,PsyD Psychotherapy processes andpractices (pp. 217-242).New forthe21stcentury York: Wiley &Sons. andtechnique.In C.Snydertheory &R.Ingram (Eds.), Handbook ofPsychological Change: integration. Journal ofPsychotherapy Integration, 1,43-54. Response to9/11,New York. treatment oftraumatized people.Paper presented atthesymposium, The Creative Arts (pp. 214-241).New York: Guilford Press. traumatic stress disorder. In B.van derKolk, A.McFarlane, &L. Weisaeth (Eds.). Traumatic Stress techniques. Newbury Park, CA:Sage Publications. Touch inPsychotherapy (pp. 3-15).New York: Guilford Press. Norton. We Are. New York: Guilford Press Therapies inMental Health (pp. 3-20).San Diego: Academic Press. 20, 144-159. boundaries from adevelopmental systemsselfpsychology perspective. Psychoanalytic Inquiry, development. HIllsdale, NJ:Lawrence Erlbaum Associates,Inc. Therapies’ Email: [email protected] others. She lives inNYC andisapsychoanalytic candidatewith Harlem Family Institute. Agenda, Nimrod, Snake Nation Review, Third Coast,Dogwood, and The North American Review, among Voices and nominatedforthree Pushcarts. She haspublishedinAlimentum, The SouthCarolina Review, Boulevard’s has won The Midwest Writing Center’s Off ChannelContest,ConnecticutPoetry Society’s Award, She isAssistantProfessor ofEnglish at LehmanCollegeandauthorofAddie Bundren isDead. She Salita holds aPh.D. S.Bryant inliterature, anM.Ed. inClinical Counseling,andanMFA inpoetry. BIOGRAPHY Be: Find stillnessinameasure ofbreath: Pause Again: Pause: Learn thelessonsofheron ancestors: A singlewhiteheron When there isonlyemptiness Try nottoflysouthwhen A stillwhiteheron Pilgrimage tocoolmud In astillbluelake When there isnothought The nightsbegintofreeze Pause onelegged Wait forasign Emerging Poet’s Award, Spoon River Poetry Review Editors’ Prize,Iron Horse Discovered Learning tofly No unbearablelongingforfreedom formscrystals And dew In theshallow watersoflakeObi Wait forspring Salita S.Bryant,PhD.,MFA By standingstill There isfreedom ofclearstillwater On thesurface Learn nottoeatthefishatmyknees Wait forthefullpulseofsun A spaciouslife A SPACIOUS LIFE 27 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 28 International Body Psychotherapy Journal The Art and Science of Somatic Praxis © Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 12,Number 1,2013pp28-41Printing ISSNNumber 2169-4745Online ISSN2168-1279 International BodyPsychotherapy Journal TheArt andScienceofSomaticPraxis MORIT HEITZLER,MSc clarity thatwill helpustomaintaintheseboundaries, anditisthismaintaining ofourclear, space whichisdefined by clearboundaries,which we will now be VERY clearabout,asitisthis strengths, eachofuswith herown personalspace,whichwe needtoappreciate andrespect, learn toseeeachotherastwo separateindividuals,eachofuswithheruniquequalities and client ontheissue,explaining in mysoftyet determinedvoice how itisthatwe will important the rightideaaboutherboundaries andmine! therapeutic boundaries!Oh, thankGod -now Iknow whattodo:Iwillmakesure thatshegets professional landscape:BOUNDARIES! anyway. In mydistress, Iclungtothefirstfirmlandmark available inmypsychological honesty oftheclient’s statement threw meoffbalance – abalance which waspretty precarious a “real, proper” therapist. I felt invaded and scared out of my wits. The intensity and naked to growstruggling up fast enough to become what I now see was my own idealised version of ofyou sothatyou inmyhand;Iwanttobepart your cannever heart goanywhere withoutme!” identification, relational trauma therapy. will explore theparadoxical nature ofboundariesandcontainmenttheirrole in engaging withchaos,confusionandvulnerabilityintheconsultingroom? This paper safe therapeuticboundaries?Canwe, astherapists,contain the impact oftraumawithout possible toby-pass theclient’s embodiedexperienceofshattered safetyby introducing containing boundariesasthefoundationofanytherapeuticwork. However, isitreally methods oftraumatherapyare highly concernedwithre-building andestablishingsafe, inner world,whichechoesstrongly inthetherapeuticrelationship. Therefore, most knowing where “I”end and the“Other” beginscreates chaosand confusion inthe client’s andtotheirsenseofidentity.of threat: bothtophysicalandemotional survival Not damage. Traumatised clientsusuallybringtotherapyanongoingbackground feeling not justasexperiencedinthemomentoftrauma,butalsolasting One ofthemostexcruciating aspectsoftraumaistheinvasion orcollapseofboundaries, Thus, withagreat sense of purposeandself-righteousness,Iembarked on lecturingthe This clienthasnoboundaries! We canNOT dotherapywithoutfirstestablishingthe The firsttimeIwasonthe receiving endofsuchadeclaration,Iwas young therapist, What wouldyou saytoaclient whotellsyou, “Iwanttogetunderyour skin;Iwanttohold Key Submitted 30July 2012;received inrevised form28February 2013;acceptedMarch 2013 The ChallengesofContainmentinTrauma Work words: complextraumawork, boundaries,containment,re-enactment, projective Broken Boundaries,InvadedTerritories: Morit Heitzler, MSc Abstract self andrelational boundariesare astheyform theblueprintofclient’s crucial, senseofself childhood scenario. The early implicit and explicit messages which were internalised around client’s senseoftheboundariesisoneways inwhichthetherapistcanattunetoclient’s inner world through their reaction to the boundaries we set. Exploring and attending to the and unconsciousresistance, submission,anger, love, andmanyotheraspects oftheir mistrust disintegration andrenewal. dangerous adventure:client andtherapistcanembark onwhatattimes feels likeavery thatof the unpredictability oftheiremergingfeelingsandimpulses.If theboundaries are safe,both consistent anddefined,itprovides asecure spacein whichbothclientandtherapistcanbrave P.179) fortheintensityofshared therapeuticjourney. If thecontainerissafe,solid, framework forthework totakeplace. The boundariescreate ‘the container’ (Heitzler 2009, andrespectfulattempt aclose,trusting connection. but theirmainfunctionistoavoid anypossibility ofreal intimacyinwhichtwopeoplecan and keepingthematbay. In thiscase,boundariesare eithernon-existentorrigidlymaintained, that theonlywaytosomehow managethepresence ofothersisby controlling, manipulating who have invaded andabusedthem. This creates suchaconfusing,chaoticmodelofrelating scars, asthepeoplewhomtheywere andrely ones meantto trust onmosthave beenthevery developmental traumaandComplexPTSD (Heitzler life-longrelational 2009,p. 179)carry normal responses tolifeandother peopleare notaccessibletothem. Those whosufferfrom time astheyhave heightenedresponses, they also shutdown agreat dealsothatmanyoftheir levels ofhyper-arousal anddissociation,astheabilitytoself-regulate isimpaired. At thesame world isnotasafeplaceandthatpeopleare nottobetrusted. They oscillatebetween extreme in emergencymode,constantlyready tofleeorfight. Theirexperiencehastoldthemthatthe on thepsychological organisationoftraumatisedpeople. Those whosufferfrom PTSD live a significantimpactnotjustduringthetraumaticevent itself, butalsocarrieslastingeffects a bulldozer over people’s normalsenseofprotection, senseofsafetyandself. This has fear andmore anchored inacceptanceofvulnerability—mineaswell astheclient’s. boundaries—in thetherapeuticrelationship hasgrown abitwith timeandislessinspired by particular. However, Iwouldliketothinkthatmyabilitywork withboundaries—orlackof principlesoftherapygenerallyandtraumain boundaries formoneofthebasic,crucial boundaries! Theholycow ofthetherapeuticfield. thererules we alllearnin toholdontoifnotthefirm year 1ofanypsychotherapy training— high idealsandpassion. first stepsintothe vast stormyoceanofthe“humanpsyche”, armedwithsolittleotherthan although Ialsofeelcompassionandlove towards thatyounger version ofmyself, bravingher for, isn’t it? journey,defined boundariesthatwillmaketherapyasafe,fruitful andthisiswhat we are here Much of ourtherapeuticwork takesplacearound boundaries.Clientsexpress conscious Boundaries inpsychotherapy practiceare establishedtocreate asafe, reliable anduseful Trauma, almostby definition,breaches people’s normalboundaries. It isasiflifewasdriving Now, years a goodfew later, I—likethatyoung therapistIoncewas—dobelieve that No wondersheneededsomethingtoholdontowhenthewaves grew higher. Andwhatis Oh dear, whatanembarrassment. To thisday, Istillcringewhenremember thosemoments, Boundaries and Trauma Boundaries BROKEN BOUNDARIES 29 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 30 International Body Psychotherapy Journal The Art and Science of Somatic Praxis my clients. trauma, aswell astestingherwillingnesstoengagewithit. of testing the therapist’s physical, emotional and mental capacity to withstand the impact of the therapist’s boundaries isalmostaprerequisite foranypossibletherapeuticprocess, andconsists to explore withherthosechambersofhellknown toheronlyinisolation. Thus, testingthe hardvery available forhertobelieve thatthetherapistcanbegenuinelyandwhole-heartedly her experience has led her to conclude that there is no reliable adult out there for her, it is from therelentless impactofthere-traumatisation ontheother. Because more oftenthannot and painwithaloving, understandingadultontheonehand,andtoprotect herselfandothers still isunbearableforher. She istornbetween conflictingimpulses: toshare theintolerablefear and bear dissociating what and was fragmenting, and tends to believe that nobody can survive client, whofeelsoverwhelmed by her traumaandonlyabletodealwiththemagnitudeofitby to feelcontainedanddefinetheemergingseparateselfhere acquires adifferent twist:the confines. Thenaturalimpulseofthechild/adolescenttotestparent’s boundariesinorder boundaries, the client is constantly busy checking the therapist’s personal and professional trustworthy. More than communicating invarious waystheexperienceofherown broken is thetransgression ofboundariesthatledtothecollapse ofallthatwasknown tobesafeand as well assettingthefoundationforherrelational patterns. MORIT HEITZLER,MSc and thepainwas beyond ignoring. Clarawasmarriedtoasuccessful businessmanwhowas take breaks toeatproperly, aswell asnotbeingabletobeatwork when theulcerflared up company, abigofficewithmanypeopleworking underher. running She resented havingto as it had an impact on her working in a prestigious life. Clara was a senior partner advertising daughter backontrack.She wasalsoconcerned about thepersistingsymptomsofherulcer, dismissed as“lovey-dovey softies”. Clarawantedsomepracticalsolutionsastohow together previous therapistswhosuggested amore understanding,loving approach towards Lisawere contribute to Lisa’s difficulty andshe was willing, reluctantly, this idea. to entertain However, she took from all these therapies was that perhaps her own attitude towards her daughter might family therapy, childpsychotherapy underthesun”, andeverything assheputit. The onething and suffered from recurring panicattacks. Clarawasatherwits’ “all endaftertrying of sorts painful stomachulcer. Now, three years later, herdaughter was withdrawn,incommunicative relationship deterioratedfrom badtoworse.More orlessat thesametime,Claradeveloped a therapist. Clara’s first therapybeganwhenherdaughter, Lisa,turned10 years oldand their past therapeuticendeavours, whichendedmostly withher“chucking” yet anotheruseless “Is shegoingtogetMEfired innotime?” anentrance!”Ithought. tobealoneforamomentand collectmyself.the opportunity “What eyes. “Do you have abathroom here?” shedemanded.“Yes,” Isaid,“it’s over here”. Iwelcomed get annoyed!” She me and the room turned her phone off and surveyed through her large black time andyou know that!”Iheard hersaying.“You bettergetyour acttogetherbefore Ireally late forherfirstsessionandwasstillatthetail-endofaphonecall:“Icanget you fired inno I willpresent avignetteofmywork thatwill illustrate thisstageintheprocess withoneof In traumawork, theclient’s around boundariesisheightenedasit suspicionandalertness In fact,thisbecameanincreasingly likelypossibilityasClaraproceeded totellmeofher Clara was45years oldwhenshefirststormedintomyconsulting room. She was15minutes Vignette 1(from thebeginningoftherapy) when Iwasnot expectingit—shehadgotten under myskin,defences. in chargeofrowing princessDiana over toseeme? Yes, Clara didfindherwayintomypsyche, the water was by a small row boat. Would you like to guess who was the person in the dream room waslocatedin alargecastlesurrounded by adeep, stormy river. The onlywaytocross which Iwasgivingatherapysession tothelatePrincess Diana. In thedream, myconsulting sense of my boundaries, I was shocked one morning when I woke up from a long dream in As muchasItriedtoremain clear, grounded andfocusedwithinmyself, maintainingmyown the therapy, asitseemedthatnotmuch elsewashappeningduringsessions. again andthat challenges—thiswas THIS—these testsandtemptations andboundary as possibleclients.Her “attack” onmynarcissistic shadow wasrelentless. I hadtoremind myself work acquaintances,someofthemsemi-famousfigures world,tosee me intheentertainment away mytalentstuckinasmallconsultingroom in West Oxford. She sentsomecolleaguesand proper publicitycampaign.Iwouldbeabletohelp more people,sheargued,ratherthenwaste and triedtoconvincemethatIcouldclimbhigherontheprofessional ladderifIgotmyselfa thatmight“giveon mypart away” myreluctance toinsistonbeingpaid. chequebook three sessionsinarow, patentlylookingforanysignsofhesitanceorawkwardness would Iforgettodeducttheextrasumofmoneyfrom hernextpayment? Then she“forgot” her on hercheque,alwayspayingmore thenshewassupposedto,waitingto see myreaction - You someextraforit!”She didagoodjobtodayandyou deserve oftenwrote thewrong figure canItipmyhair-dresserconsidered ormasseuseandIcannottipyou? agoodsession.“Why sophisticated, subtleattempts.She offered meextramoneywhenshehadwhat shared journey. She hadmethermatch.Aftersomenegotiationwe agreed onaregular timeandsobeganour able tooffer, whichisaweekly regular session.”Isawaglimmerofappreciation inClara’s eyes. priorities. If you choosetowork withme,Iwillexpectthesamelevel ofcommitmentthatIam It isnotalwayseasy tojugglealltheresponsibilities inawoman’s life,butwe canchooseour by abusypractice. saying:“Iunderstandyour situation.Iamabusywomanmyselfandrun week!” justtobehere Irespondedyou every cannotexpectmetocanceleverything calmly run alargeoffice,surely busyand wasattacked.“Icannotdothat.Iam very the firstboundary condition wasthatshemustcometotherapyweekly, ataregular time.AssoonasIpresented it, you todo,you’re out.No secondchance.” towards vulnerabilityofanykindandageneralsensethreat: “If you willnotdowhatIexpect tohelpherdaughter,incompetent therapists,amotherstruggling impatienceandintolerance ofit.” but Iamnotgoing to bepart There were alsosomeimplicit themes, amongthem have someaccesstomyintestine,aslongitdoesnotinvolve me. You candoyour business, symptoms, sosheexpressed outherulceratthesametime. somehopethatIcouldsort her. However, she was aware that I was a body psychotherapist and worked with psychosomatic issues. No, theproblem wasclearlyLisa,andshecametogetsomeguidanceashow tohandle way, Claramadeitclearfrom thefirstsessionthatshewasnotintherapytowork withher drink”. They hadason,whomClaraadored, whowasthen9years old.In heruncompromising often away on work trips. He was a powerful, charismatic person, who often “had too much to The main charge was invested in trying to get to me, trying toseducemeorbreak togetme,trying myboundaries. The mainchargewasinvested intrying Clara alsotriedtobe“helpful”. She offered mypractice inadvertising meherexpertise Clara’s testsofmyboundariesgrew from obvious straightforward, attackstomore I agreed towork withClara,whichshe,herself, seemedtohave takenforgranted. My The messageIwasgettingquiteclear:“Stay awayfrom meandmyinnerworld! You may BROKEN BOUNDARIES 31 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 32 International Body Psychotherapy Journal The Art and Science of Somatic Praxis MORIT HEITZLER,MSc to herson,who becamethemainsource ofherpleasure andjoy. relationship with her daughter wasrather distant and grew even colder whenshe gave birth the baby totermby herfatherwho wantedagrandchild.Clara’sbut waspersuadedto carry business associates who was 15 years older than she was. She resented her first pregnancy was now andearlyinher30’s, running toherfather’s great delight,shemarriedoneofhis studies inthefieldofeconomics andbusiness. In her20’s, Clarajoinedthe companyshe withdrew his“special attention”, Clara’s butsupported wishtocontinueheracademic sexual abusecarriedonwell into her14thyear, Her whenshebeganmenstruating. father anybody else.” are alike.Only thetwoofuscanunderstandeachother. We are stronger andbetterthan reassure don’t herby saying: “They meananything.It’s you andme,darling. You andI womenhe pickedupinbars,andheusedtowitnessed himhavingsexwithyoung drunk heavily andregularly abusedhersexuallywhenhecamebackfrom histravels. She often tyrant Clarahadbecome.During thattime,Ilaterlearned,Clara’s drinking fatherstarted to lookafterherbutgot“chucked” one by oneasnoneofthemcouldstanduptothelittle get hissonback,andClarawasintroduced toasuccessionofnannieswhowere supposed young son, Clara’s half-brother, withher. The fatherdeclared legalwarfare on her, to trying andsexyunderwear.expensive perfumes world!” He usedtoshower Clarawithgiftsthatwere notsuitableforheryoung age,like determination andstrength shegotfrom me. Wait the untilshegetsolder—she willrule is MYdaughter, she’s gotsomeofherItalian temperfrom her mother, buthermotivation, congratulate Claraonhercommandover thehousehold andsaytoherstepmother:“Clara depression.and deeperintoapostpartum On return from histravels, herfatherwould Hertantrums. fatherwasoftenawayonbusinesstripsandherstepmothersinkingdeeper her peergroup, thehouseholdwithhertemper butathomeshewasoutofcontrol andruled Sheviolence started. wasagood,motivated studentatschoolandratherpopularamongst neighbours andworkmen. Afterheryounger brother wasborn,Clara’s outburstsofrageand various applicationformsandofficialdocumentsas well astranslatingconversations with father andClara.Clara,7years ofagethen,usedtohelpheryoung stepmotherincompleting woman, aRomanian student,whogotpregnant monthsofmoving withinafew inwith to her, asdidherfather. Soon aftermoving backtoEngland, herfathermarriedayounger She feltdisgustedby hermother’s opendisplayofweakness andrejected allconnections daughter. Clararesented thosevisitsand,asshegrew older, didallshecouldtoavoid them. her visits were marked by the mother’s uncontrollable tears, howling and clinging onto her following several suicideattempts.From thenon,Clarasawhermotheronlyonceayear, and mother wasleftinItaly, herhomeland,andwascommittedsoonaftertoapsychiatric ward assets and Clara, their only daughter, he moved of origin. Clara’s back to England, his country divorce hisdepressed wife,Clara’s mother. Taking oftheirshared withhimthelargerpart isolating marginandmanagedtogetintothecastle?” being seducedby whom? Whose inflatedegohadtosurrender? Whocrossed theprotective yet manipulation ofmygrandiosity. isbeingcommunicatedhere?” is Iwondered, “What “Who This story wasconveyed tomeby Clarainanonchalant, matter-of-factway.This story It helped At the age of 12, Clara was sent to boarding school where she became a star pupil. The When Claraturned10years old,herstepmotherwent backtohercountry, takingher When Clarawas6years old,hercharismatic,successfulfatherhadfinallymanagedto Things beguntomakemore senseasClara’s wasslowly revealed. lifestory I noticedmycountertransference feelingsaswell astheunconsciousreaction totheseductive an enmeshment encouragedby thefather’s narcissistic oftheirrelationship. view to anenmeshment withherfatherthatwasthinly disguisedasacelebrationof independence— attachment needs,herfearofabandonment andherrage. and This ledtohertempertantrums adoption ofamasculinefaçade. Underneath thisfaçade,Clarawasplagued by herunfulfilled had tobelikehim,whichled toatotalrejection oftheweak, collapsedfeminine andto the was oftenabsentbutstillthe only powerful adultinhervicinity. In order topleasehim,she vulnerability thatmightleadto atotalcollapsepushedClaratoturntowards herfather, who of thisunmanageableresponsibility, thelack ofattendancetoherown needsandthefearof get outofbed,mydearchild,itisonlyyou who makesmegoonliving.” The combination sessions, Claraoftenrecalled hermothersaying:“You are theonlyonewhocanmakeme her motherastheroles reversed andhermotherbecamemore dependentonher. In our by beingstrong, physicallyandemotionally. She developed agrowing contempttowards her moodsandenergeticpresence grew more andmore confusingforherchild.Claracoped fully available tointeractwith herdaughter, butasherdepression grew deeper, theshiftsin goal” (Ogden, 2006,p.50-51). towards dischargeofhigharousal thantowards the purposefulachievement ofaspecific acting-out behaviour… Their physicalmovement maybeuncontained,geared more recovering from stress, show poorimpulsecontrol, fearabandonmentandengagein affective communication” (Ogden, 2006,p. 50). not, the child is unsure of the reliability of the caregiver response to his or her somatic and inconsistent in her availability, sometimes allowing and encouraging proximity and sometimes in herresponse totheinfant,”explains Pat Ogden (2006,p.50). “Because thecaregiver is infant whodevelops insecure-ambivalent attachmentpatternsisinconsistentandunpredictable before (Schore, 1994;2003). ability torelate oreven rightatbirth toselfandothersfrom much earlier stagesoflife,starting confirms(Stern,observation 1985)that attachmentpatternsbegintoshapeandimpactthe boundaries around 2 years of age. Nevertheless, recent research into neuroscience and infant recognition developing withthemother. has elaboratedtheoriginsofchild’s senseofselfintheintersubjective dialogueofmutual and the other’s boundaries. And from a relational and feminist perspective, Benjamin (1998) ‘separation-individuation’ process, that the child’s healthy impulseslead towards exploring her 1994),orwhatMahleris intheindividuationstage(Johnson, (1975),following Klein,callsthe boundaries develops intheinteractionwithourfirstattachmentfigure, typicallythemother. It when boundariesare initiallycreated, thepicture becomesmore complex. abuse her. However, ifwe considerthedevelopmental processes andaskourselves how and Clara’s boundarieswere breached: whenshewas 10 years old andherfather began tosexually relational stance,hersymptoms,butitleftmewondering: where dowe begin? me tomakesenseofher:herbody, andcareer, hermanners,choiceofpartners her Clara’s motherwasaloving, warmwoman. When shefeltwell withinherself, shewas infantscharacteristicallyappearirritable,haveShe difficulty continues:“These I cametothinkofClara’s motherofthe attachmentstyleasinsecure-ambivalent: “The Typically, phasefor the establishmentof developmentalself-other models locatethe crucial thesensealsoofourphysical,emotionalandpsychic As acentralaspectofour‘sense ofself’, In termsoftrauma,itmightlooklikeaneasytasktodefinethepointintimeatwhich Discussion of Vignette 1 BROKEN BOUNDARIES 33 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 34 International Body Psychotherapy Journal The Art and Science of Somatic Praxis MORIT HEITZLER,MSc both strong women, bothinourlate40’s, whowere livinginaforeign land. We both had If Iwas nottobe“chucked”, Iwas tobemergedwith. Carla hadnosenseofherinternal boundaries. This wasplayed outinherrelationship withme. as anythingotherthanherfather’s extension,anextralimbofhisphysicalandenergeticbody. always thegirlthatDaddy adored. It hard wasvery andconfusingforher to considerherself nothing inherlifehad prepared her for thatquest.She always did whatDaddy wanted,shewas withthoseexistentialquestionsforthe firsttimeand was herlifeallabout?Clara struggling erected inorder toprotect herself, sheactuallydidnothave aclearsenseofherselfatall. scary, edges.Clarahadcometorealise thatunderneaththerigidrelational boundariesshehad outer containergrew, towards theprocess tookusfurther unknown, attimesbreathtakingly firm holdofthefamiliartherapeuticframe. However, inthe asthesenseofsafetyand trust going to be there, even ifshecouldnot bribe mewith money orfame. I alsorelaxed into the been gained. Clara relaxed into our at weeklyleast to some degree rhythm, trusting that I was and thoseblows thatagreater appreciation andrespect towards theircontainingfunction had several attacksand itwasthrough withstandingthisbuffeting boundaries oftherapysurvived next stageoftherapywasunfolding. her and her father, and, as Clara sensed this, she was more than ready to enmesh with me. The wasinvadedcommunicated onlyoncemyown by thedream. boundary Iwasnow more “like” needs. This first-handknowledge inunderstandingClara’s wascrucial innerworld,anditwas have somebodygetundermyskin,notrespecting my“no’s” andmanipulating myinfantile surrendered totheneedbebigandpowerful. Moreover, now Iknew whatitfeltliketo me feel(ratherthanmerely understand)theirresistible seductionofnarcissistic grandiosity. plays intheclient-therapistinteractionandprocessing oftrauma.In thiscase,Claramade (Soth, 2005)ofherown lifestory. done toher, andinherstyleofattacksheunconsciouslycommunicatedtomesomefragments wasindeedjustified. She attackedmyboundaries, desirable pedestalofglory repeating whatwas thus gainingherrespect. placed myselfinthecampof“strong people”, likeherand—more father, importantly—her abandonment. Moreover, by standingmyground rightatthebeginningofourinteraction,I and commitment,Itookmyfirstsignificantstepin relatingtoClara’s unconsciousfearof re-enacted over andover againby “chucking” people. and rejecting relational style,whichperpetuatedherabandonmentfantasy, afantasythatwas both parents. In herattempttodealwiththisinnerchaos,Claradeveloped aharsh,controlling from abandoningherashehadabandonedweak mother. andstopherfather reality senseofpanic,arisingfrom adesperateimpulsetotry wasapervasive Clara was working very hard,Clara wasworking very explicitly, toprove tomethatwe were “the same”: we were Who was Clara? What was it she really wanted? What was good or bad in her eyes? What About ayear later, Clara and Iwere deeplyimmersed in our chaotic dynamic. The outer In dreaming aboutClarafacilitatingmypositionasPrincess Diana’s therapist,I,likeher, I have writtenelsewhere (Heitzler, 2011)aboutthecentralrole whichprojective identification Claraneededtocheckhow strong Ireally wasandwhethermy claimtoaseatonthat In insistingonaregular commitmenttotherapyandexplicitlystatingmyavailability Her confusionaround herboundarieswasfannedby implicitandexplicitmessagesfrom Clara’s senseofselfappeared butherhidden,inner strong anddeterminedonthesurface, Vignette 2(from alaterphaseofthetherapy) not beingableto feelthematall. When Ithensuggestedshebreathe ofherbody intothatpart the basisofthat impression Ithen drew herattentionto her shoulderbladesandshereported actually hanging rather weakly from her body, limp and as if disconnected at the joints. On cutting energyinherarms. I invitedhertoactuallysense and thendescribeit,shesaidcouldfeelsomekindofharsh, the sensationsinherarms.She noticedsomefeeling ofagitationinherlower arms,andwhen her physical symptoms. Clara was sitting on the mattress in my consulting room, exploring addition tomore frequent ulcerattacksshealsodeveloped ared, inflamedrashonbotharms. calmed down noticeablysincewe hadbegunourwork togethernow flared upagain,andin her growing rage,fear, confusionandneedwassomatisation. The physicalsymptomsthathad not really afford toabandonme,herdistress went more unconsciousandtheonlyoutletfor knew, shesaid,thatIwouldcomeback. have anysensethatIwasabandoningheratall,as we hadacleardateformyreturn andshe of ourlastsessionbefore thebreak drew near. separation. AlthoughIhadannounceditalongtimeinadvance, Claragrew restless asthetime “progress”:congratulatory myholiday—fourweeks ofsummerbreak—and ourfirstlong positive feedback.She wasmakingprogress, shewasbeing“good”. her timeandattention.Meanwhile, shewashappilybaskinginthewarmraysofmyapproving, Clara wasabletomaintainsomeboundarieswithherfather, rejecting hisincessantdemandsfor impatience towards thedaughter’s needsandfearsasherrejection ofherown vulnerability. dreams, brilliantinsights.Her compassiontowards herdaughtergrew, aswe interpreted her with meanddoingherbesttopleasewhatever sheimaginedmyunvoiced wishestobe. was trapped,justlikeClarawas,lockedintoaone-dimensionalimage—“strong asDaddy”. way. personIwas,inevery what anamazing,wholesomeandgenerallyperfect So, in effect,I aspects ofmypersonality, withnosplittingatall. This wouldbejustanotherproof confirming want todisplaymyvulnerabilityinorder toshow herhow Icouldintegrateall wonderfully display my power—otherwise I would lose her respect and I would be “chucked”. I did not now as atherapist. ofmyselftoemergebutstill,itdid not comeeasytome,definitelyinmy role delicate part trauma andculturalimprints.Ihave worked hard inyears oftherapytoenablethathidden, vulnerability andneedinesshasindeedbeenwell concealed,alegacyofmyown generational almost exclusively asindependentandstrong. “Fair enough,”Ithoughttomyself. My own level andrespected whatIwasdisclosingaboutmyself, butshecontinuedtoexperienceme feel mydependency, therefore, shecouldnotimagineit.She mightagree onaconceptual people inmylifethatIdiddependupon,butClararejected this,sayingthatshedidnot “out ofthebox” andthiswasthekeytooursuccess.How couldIarguewiththis? anybody else,sheargued,aswe were powerful andindependent. We were bothabletothink successful careers and had people depending on us and needing us. Neither of us needed In spiteofthatlocalisedagitation,Ihadtheimpression that,onthewhole,herarmswere It wasfourweeks before theimpendingdateofmyholiday;ClaraandIwere working with Still, as the break was approaching, cold and distant. she grewBut somewhat as she could She couldnotopenlyshow herfearofabandonmentandfirmlymaintainedthatshedidnot But somecloudswere gatheringonthehorizon, threatening theblueskyofourself- She placedgreat emphasisonbeinga“good client”, producing memories,deep meaningful Whilst thiswashappeningbetween usexplicitly, onanimplicitlevel Clarawasbusymerging In myrelationship withClarauptothatmoment,Ifelt Ihadtobestrong; Ihadto I triedattimestobringsomeofmyreality intotheroom, by sayingthatthere were BROKEN BOUNDARIES 35 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 36 International Body Psychotherapy Journal The Art and Science of Somatic Praxis and disappearforever. the endofme: Iwasgoingtobesacrificed, tobeswallowed whole intoanamorphous “us” moment, thatforever unattainable imageoftotalintimacy, yet itfeltasifwasgoingtobe us tomerge,beone.Iwas about todisappear!Confusingly, appealatthat it had acertain More through mymind,Ifeltinvaded thanthesexualfantasydarting by fear. She wanted motherly cocoon. my bellytochest,warmlove flowing through myarms,embracingmeandherinasoft, leaning againstmine,herheadresting onmyshoulder. Ifeltawarmwave oflove risingfrom body tinglingwiththeenergeticchargeofmoment. Icouldfeelmyself holdingmybreath,obviously struggling. myheademptyofallthoughts, to eachother. Icouldseeherfaceturningred asher breath grew rapidand shallow. She was couple more steps. “Closer”, she whispered. I drew closer; we were now close standing very her own impulsesinthischargedmoment.“Closer”, hervoice wasalmostpleading.Itooka hold hertightagainstmychest,butIstoppedmyself, wantingtogive herthespacetoexplore sensations inmybody, Isteppedtowards her. Ihadastrong impulse totakeherinmyarmsand She lookednoticeablyyounger. “Comehere”, shesaid.Her voice waspleading.Following the the sadisticallypowerful father. Now shecanbe‘the Child’.” I thought to myself, “Now Iam embodying the confusing rejecting-inviting mother, as well as looked ather:surprisingly, sheseemedrelieved. She even smiled.“Perhaps itiseasieronher”, focused onmyselfandmyreactions toherrejection thatIwasnolongerreally seeingClara.I you!” I was shocked and upset to realise what I was experiencing. I noticed that I was so the power now; I will show you what you get when you reject me! Iam going to play with “Come here”, Icommanded.Claramoved towards me.“Stop,” Ibarked almostimmediately. she said“stop”. It waspainful;Ididnotlikebeinginthatspace.gladto have myturn. rejected, toholdonthatslitherofhopewhichhadbeenevoked when I felthurt, scared, trying want meafterall!Istoppedandwe lookedateachother, assessingthesituation. said. There beatingfasterwithhope:shedoes wassomeurgencyinhervoice andIfeltmyheart anymore”, away, Ifoundmyselfthinking.drew further feelingrathermiserable.“Stop”, she eyes; asImovedher cold,harshvoice, herangry away, sank.“She myheart doesnotlikeme to follow mylead? body. Iheldmybreath, waitingforherresponse. meenough Couldshedoit?trust was invitedtorelinquish control andspontaneously explore theunpredictable domainofher things. Which oneare you goingtogowith?” We were now inunfamiliarterritory, andClara entirely unfamiliarexperience.“It’s confusing,isn’t it?“Isaid.“Your bodywantstwoopposite “Come here.” place between hershoulderbladesandallow anexpression. The words thatemergedwere: expression. Her armswantedtosayme:“Go away.” Ithenaskedhertoconnectthesoft young.changed, shefeltsoft,weepy andvery —my words were “intotheplacewhere herarmscomefrom” —surprisingly, hersensations MORIT HEITZLER,MSc My bodyrelaxed, butthen...“Closer”, Iheard herwhisperinmyear andmybloodfroze. “Closer”, now, shewasopenlycrying asItookherinmyarmsandheldher, herbody I feltthewarmthcomingbacktomybody. IwasmyselfagainandlookedatClara. In thesilencethatfollowed I sensedasinister, dark satisfactionrisingwithinme:“Ihave In thismoment, we were Clara’s quite far apart; face was blank, not conveying any emotions. Clara drew adeepbreath, sensingintoherbody. “Go away”, shecommanded.Itookin Clara looked confused—for her, attending to conflicting messageswithin herself wasan When Iaskedhertoallow someexpression towards mefrom herarms,Clara’s wasaverbal The child,sensing hermother’s betrayal,turns totheonlyotheravailable parental figure— or depressed toprotect herdaughter andtherefore abandons hertothefather’s lawless power. More often than not, that mother is aware of the abuse taking place, but is too afraid, weak has herselfbeenphysicallyabused and/orsadisticallyhumiliatedanddegradedby thefather. breed abusive dynamics, themotherisaweak, submissive andchild-likefigure, whooften cannot afford toletgoofherattachmenthim.Often, asinClara’s case,infamiliesthat sense ofinternalboundaries. especiallyintermsofaddressingprinciples underlyingmywork their withtraumasurvivors, for herself. I am. Will you helpmetofindout?” some timeasshewassearching forwords. really the love you want from me?” Clara was visibly moved and we stood there quietly for under your intheirhand. skinandholdsyour heart You’ve lived likethatall your life.Is that then.” Claradrew adeepbreath. Icontinued:“You know whatit’s likewhensomebodygets passed. Clara’s angry, despairingstatementstillechoed intheroom. vein, anditfeltgood.It feltlikethebestplacetobe.Iopenedmyeyes. Onlysecondshad afew alive, surrounded by many more bubble-like people; we were all together in that same huge uswho-knows-where;universal bloodstream carry we didnotneedtoknow where. We were bubble, floatinghappily by myside. We were holdinghands,lettingthesteadyrhythmof a littlebubble,floatinginsidethelarge vein ofthe Universe. Next tomewasClara,alsoasmall were one,where allbeingsare one,andnobodyisreally separated.Ihad animageofmyselfas move. Iconnectedtothatrealm Iclosedmyeyes andopenedmyheart. inwhichClaraandI Clara’s psyche depended onmynext hadbeenwaitingforalongtimeandthateverything noweverything depends onthenextmove feltthatthiswasamoment you take?Icertainly THE momentyou have beenwaitingforallyour life? isfallingintoplaceand That everything that you cannever goanywhere withoutme!” want to getunderofyouyour so inmy skin; Iwant hand;Iwant to holdbepart your heart the statementIquotedatbeginningofthispaper, aswithrageanddespairClarasaid:“I is where you endandIbegin. This isyou andthisisme.” territory, anotherexistence?” love and sacrificed on the altar of complete enmeshment. How can we find together another and more ofher. That iswhatitfeelsliketobesimultaneouslyenslaved by thelongingfor None ofthesewasever enough.She alwayswantedmore, likeherfatherwhowantedmore ‘us’ shehadwithherfather, ortheconfusingrejection-closeness shehadwithhermother. time. She hasnosenseofwhere sheendsandIbegin.It iseitherthisamorphous,merged At the heart ofmyworkAt liestheunderstandingthatchildwhowasabused by theheart herfather I have describedthissessioninsomedetail,asit illustrates someofthekeydynamicsand And sobeganthenextstageofourjourney, inwhichClarawaslooking,forthefirsttime, “I don’t know what kindoflove Iwant.don’t know whatlove is. Idon’t even know who “I don’t wantyou togetundermyskin,”Isaidcalmly. “Iwillnotbeabletolove you I felttheworldstoppingaround me.Do you know thosemomentswhenyou feelthatthisis Clara turnedtome,herfacecontorted. That wasthemomentwhenIfacedagainwith “I cannotcomeanycloser,”“This IsaidsoftlytoClara,stillholdingherfirmlyinmyarms. iswhatitfeelslike”,“This hasbeenherinternalreality Ithoughttomyself. allthis “This Discussion of Vignette 2 BROKEN BOUNDARIES 37 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 38 International Body Psychotherapy Journal The Art and Science of Somatic Praxis internal boundaries gotlost. about ishow thatchargedmoment impactedme,thetherapist,as inevitablyItoofeltthatmy its intensity, by andwithinthetherapeuticdyad. What Ithinkwouldbeusefulforusto needs tohappensothattheprimal conflictcanbefullyexperienced,addressed andheld,inall expressed in her whole bodymind. This, in my view, therapeutic moment; it is an important rigid internal boundaries on the one hand and non-existent boundaries on the other were fully way theessentialfragmentsof her blueprintfortheexperienceoflove. The shifts between too- urge togetundermyskinand becomeonewithme,assemblingtogetherinanunconscious I have justdescribed. and capturedseparation that intensified theunconscious dynamic until iterupted us both, as abusive father. forsome timeanditwasourlooming Allthiswasbrewing underthesurface of theconflictemerged:underlyingrageandfear, theneedto reject andprotest againstthe order tore-find thelostsenseofherself grew stronger, andwithit,unavoidably, theotherside (Heitzler, 2011). within the safety of the therapeutic relationship that holds the potential for transformation object andbecamea“star client”, doingherutmost topleaseme. rejected by Clara.She thentookthefamiliarrole ofthe“good girl”, beingherdaddy’s pleasing felt secure and reassured by my commitment, her dependency went underground and was and asanattempttore-create the“special” relationship shehadwithherfather. Once she Clara’s attemptsto“bribe” mewithmoneyandfameasawayofsecuringherplaceinmylife her tobelikeme.Her suppressed dependencymanifestedatthe beginningofourprocess in father ontome,shere-enacted theenmeshmentdynamicby wantingmetobelikeher, wanting of herprocess Ihave outlinedabove. Having successfullyprojected herpowerful, omnipotent nothing ever feelssafeorsolid. and uncontainedinnerreality inwhichthelinebetween perpetratorandvictimisblurred, and and ontheothertomergewithhiminorder tosecure theattachmentbond,leadtoachaotic The contradictingimpulses,ontheonehandtoreject theabuserinorder toprotect herself, of self, then,consistsofbeingessentiallybad,whichexacerbatesherfearabandoned. maintain theirsecret bond,forwhichshefeelshugelyresponsible andguilty. Her internalsense manifesting in herulcer) or turned into self-harm. Her dependency on the abuserleads her to father. Her rage,terror anddisgustare suppressed andoftensomatised(inClara’s case losesconnectionwithasenseofherownthe childfurther Self. position. This wastheonlysaferelational identifyingwiththeabuser, positionClaraever knew: taking onherselftherole oftherejected weak femaleandprotecting hermother’s inflatedpower continued thelineofabuse,acceptinghermother’s unconsciouslyprojected vulnerability, so all femininefigures whomshe rejected. It isinteresting tonotethatLisa,Clara’s daughter, of her, projected allhervulnerabilityontomother, hernanniesand,lateron,daughter: Clara, whose identification with her charismatic father was encouraged by his narcissistic use with herfeelingsofvulnerabilityandterror basedonprojecting themontoothersaround her. with theabuserhelpsherfeelempowered and asaconsequenceshedevelops awayofdealing him aswell asrejecting herexperienceofherselfashelplessandvictimised. The identification the father—andidentifieswithhim. In thisway, sheisattemptingtokeepherbondwith MORIT HEITZLER,MSc In thatsession,Claraopenlydisplayed herneedto control andreject me,aswell asher primal Moreover, asourrelationship matured andstabilised,theimpulsetoenmeshwithmein However, thisrelentless conflicthad to be re-enacted between us,asitisthe re-enactment This conflictwasthemaindrivingforce behindClara’s feelingstowards meduringthatphase She exists as a sexual object, as a narcissistic mirror or as an extension of the omnipotent my work withClara,we focusedonworking withskin-boundaries(Rothschild, 2000,p.143) sense ofthecontainer, gainedconnection andappreciation leadingtoanewly oftheself. In home, tothemselves. fragmenting onadailybasis,they live inexile,dis-embodied,notabletofind their wayback to theirbodyandwiththathave lostasenseoftheirphysical container. Dissociating and into direct contactwithourselves. Many peoplewhohave been traumatised have lostaccess hold ourselves. It is this felt sense of our physical existence that brings us back to reality and We oureyes pinchourselves, orarms,jumpupanddown rub orunconsciouslystroke and even thinking—toourbodiestoregain asenseofreality andgrounding: asenseofourselves. as acontainer, canreside. providing theconcrete, physicalshellwhere theamorphous“self” them. More than assuringsafety, the“somatic senseofboundaries” (Ogden, 2006,p.226) serves I wouldliketothinkaboutworking withthebody to create boundaries,ratherthenendangering with theclient’s bodyandyours?” abouttheerotic dynamics—howtouch?” “What doyou holdtheboundaries whenyou work whilst working withthebody. “Don’t you fearcrossing theclient’s boundarieswhenyou offer beliefs andassumptionsaboutbeingloved. prompted hertowonderwhoshereally was,whathersenseofselfwasandtoquestion the fragilityofherown conceptandfeelingoflove. boundariesaswell aswithanew This commitment toherdesperateneedbeloved, thatIallowed Claratogetintouchwith I willnotbeabletolove you then.” past dynamicasitmanifestedinthepresent, andtosay:“Idon’t wantyou togetundermyskin; see her:toherseparatenessANDouroneness. This thenenabledmetoaddress the contain herinawaythathadnotbeenpossible until then.From thatplace,Iwasabletoreally understood inmybonestheprimaldynamicsinvading Clara’s psyche, Iwasabletoholdand defined by itsboundaries. sacrifice onthealtarofmergingwithherfather: own senseofherselfasalivingorganism, that significantmomentoffearIunderstooddeeplyjustwhatitwasClarahadto relational knowing’, communicatedsubliminallyandpre-reflexively body-to-body). It wasat verbal understanding of what it was like to be Clara (what Lyons-Ruth (1998) calls ‘implicit here—go away” urges,thatIreally “got” it.In that“here &now” instant,Igainedanon- and imagesthattookover mybodymindasClaraand Iwere grapplingwith her“come but itwasthrough thedream Ishared withyou previously andthrough thefeelings,sensations self-states—that constitutethefragmented,shiftingtorrents ofherinnerchaos. embodied senseofthecharacterswhoinhabitherpsyche, ofherself—ordissociated thoseparts I gainedasomatic,implicitunderstandingofClara’s inner dynamic,includingadetailed consciousness.” (Heitzler, 2011). thattheclientisnotyet readyexperience, containandholdself-parts tointegrateinto information, Iseeprojective identificationand re-enactment asacalltothetherapist Working with the physical boundaries of the body can re-establish and strengthen the felt Often whenwe feelungrounded, dissociated,shockedorover-tired we turn—without thorough exploration.InThese are questionswhichdeserve thispaper, important however, Being abodypsychotherapist, Iamoftenaskedaboutmaintainingtherapeuticboundaries I dobelieve thatitwasby statingmyregained boundarieswhilstexpressing my within myself those moments of horror,As I survived that edge of disintegration, as I Up untilthatmoment, I hadbeenabletothinkaboutandanalyse the relational matrix, In losingmyselfandbecomingtherejected childandthenthesadisticallypowerful father, I have writtenelsewhere: “More thantheinsightintofirst-handunconscious BROKEN BOUNDARIES 39 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 40 International Body Psychotherapy Journal The Art and Science of Somatic Praxis be abletofindmywayhome. confused andlost,asIknew, inmyown embodiedbeing—thatultimatelyIwouldalways tests andtrialsinmywork withClara. This iswhatenabledmeto becomeenmeshed, regain inourown themafresh, we bodiesafeltsenseofwho we thencarry really are. ourselves togothoseedges inourown journey, toloseourown internalboundariesand of its untamed terrains, the experience of disintegration is not a foreign one. If we allow ofthehumanpsychewho are fascinatedbyandcommittedtotheexploration themystery psyche that hold the keys totransformation. However, I dobelieve that for many of us are, therefore, notavailable tobesufficientlyaffected by thetraumaonthoselayers ofthe available fortherequisite intensityoffeelingsinvasion, confusionanddespair. They and whatisknown, totheirfamiliardefinedsenseofself, are unlikelytobesufficiently it.of surviving regaining themagain,thatsheisabletostepintotheclient’s reality ways andembodynew ebbs andflows,rupture-and-repair tothe process oflosingherinternalboundariesand the successor failure ofthehealingprocess. It is through the therapist’s availability tothe boundariesoftherapistandclientalikethatdeterminesit isthework withtheinternal anindispensablepre-conditionpreserved—as foranyprocess totakeplace—Ibelieve that tobearandmakesenseofthemadnessincestuousentanglement. dyad isstruggling boundaries, herown senseofself, thatformsthebattleground inwhichthetherapeutic demolish theexternalboundaries,itisunconsciousattackontherapist’s internal re-enactto invade the therapist’s this dynamic by trying boundaries. More than aiming to get avisceralsenseoftheirinvaded, confusinginnerreality (Heitzler, 2011). the safetyoftherapeuticenvironment intheunconscioushopethattherapistwill of communicationare non-verbal. Clients re-enact fragmentsoftheabusive dynamicin iceberg isoftentooshamefulorvulnerable-makingtoexpress. Therefore, themainmeans and splitoffinanattemptby itssanity, theorganismtopreserve theconscioustipof to thetherapistthismulti-layered tormented reality. With mostofitbeingunconscious journey towards herself. tool ofpower toseduceandcontrol others, but asaresource, anally, areliable guide on her way, new months,Clarawasabletoinhabitherbodyinavery few nolongerasanobjector sensations andmindfullyfollowing signsofexpansionandcontractioninthebody. Within a me. Our work atthatstagewasmore physicalthanverbal andinvolved sensingsubtlebody was able to define her personal space by indicating her felt sense of distance and closeness to muscle tensing(Rothschild, 2000,p.135) andvisualboundaries(Rothschild, 2000,p.146). MORIT HEITZLER,MSc It wasthiscapacitytoloseandre-gain my sense ofselfthatresourced meduringthe Therapists whofortheirown reasons needtoclingthesecurityofwhattheyknow As muchastheexternalboundariesoftherapeuticframeneedto be heldand As invasion ofboundarieswasatthecore oftheabusive relationship, theclientwill When firstcomingtotherapy, thetraumatisedpersonfindsitimpossibletoconvey Later on,asClara’s senseofselfgrew, we worked withinterpersonalboundaries,andClara Conclusion Rothschild, B. (2000) Ogden, P. (2006)Trauma andtheBody-ASensorimotor Approach toPsychotherapy. Norton & Mahler, M.S.,Pine, F. &Bergman, A.(1975). The Psychological Birth oftheHuman Infant: Lyons-Ruth, K.(1998) Implicit Relational Knowing: Its role indevelopment andpsychoanalytic Johnson, S.(1994)Character Styles . Norton &Company Heitzler, M.(2011)Crowded Intimacy -Engaging Multiple Enactments inComplex Trauma Work. Heitzler, M.(2009)Towards anIntegrative Model of Trauma Therapy Body . In: Contemporary Benjamin, J.(1998).Like Subjects, Love Objects: Essays onRecognition andSexual Difference. Yale REFERENCES courses intheUKandIsrael andsheregularly leadsworkshops andgroups. and asylumseekers,sufferingfrom awidevariety ofPTSD symptoms. has gainedawealth ofexperienceinworking withtraumatisedclients,whichincluderefugees oftheMaudsleyService Hospital, London,andattheOxford Stress and Trauma Centre, Morit Family Constellations. Body Psychotherapy, attachment theory, sensori-motor, EMDR,modernneuroscience and approach, incorporating—within an overall relational perspective—Somatic Trauma Therapy, diverse backgrounds. Morit specialisesin trauma work, andhasdeveloped herown integrative Oxford, U.K.She andlong-termwork withawiderangeofclientsfrom offersbothshort- Morit Heitzler andtrainerwithaprivate practicein isanexperiencedtherapist,supervisor BIOGRAPHY Stern, D.N.(1985).Interpersonal World oftheInfant: A View from Psychoanalysis andDevelopment Soth, M.(2005)Embodied Countertransference. in: Totton, N.(2005)New Dimensions inBody Schore, A.(2003)AffectRegulation andRepair ofSelf. Lawrence Erlbaum: Hove Schore, A.(1994)Affectregulation andtheoriginofself.Lawrence Erlbaum: Hove Email: [email protected] Website www.heitzler.co.uk. Company Symbiosis andIndividuation. Basic Books treatment. Infant Mental Health Journal, 19,282-289 The British Journal ofPsychotherapy Integration, Volume 8,Issue 1,15-26 Psychotherapy - The Chiron Approach. L.(ed)Hove, Hartley Routledge University Press She hasbeenmakingacontributiontotheprofession by teachingonvarious training In awiderangeofcontextsbothintheUKandIsrael, includingatthe Traumatic Stress Psychology. Basic Books Psychotherapy. Maidenhead: OUP Norton &Company The Body Remembers- of The Psychophysiology Trauma and Trauma Treatment. BROKEN BOUNDARIES

41 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 42 International Body Psychotherapy Journal The Art and Science of Somatic Praxis © Author andUSABP/EABP. Reprints [email protected] Volume 12,Number 1,2013pp42-55Printing ISSNNumber 2169-4745Online ISSN2168-1279 International BodyPsychotherapy Journal TheArt andScienceofSomaticPraxis LIVIA SHAPIRO as stagesofhuman development with aninherently therapeutic nature, maybeconsidered Actions as understood by Aposhyan may not be overtly psychotherapeutic but, when presented felt, fostered, andunderstood (Lohman,1999).Similar toyoga practice,theFive Fundamental a mind-body connection in which awareness of one’s subtle body and energetic movements is Yoga practicedasaroutine over timeseemstofacilitatenotonlyaphysicaladeptness, but also practice isnotpsychotherapy, ithasbeenshown tobeinherently therapeutic(Milligan, 2006). identify,to observe, theprocess ofchangeinpsychotherapy. andsupport While yoga asana Yoga Based BodyPsychotherapy usesyoga postures paired withnaturalmovement patterning with Susan Aposhyan’s framework,known inbodypsychotherapy astheInteraction Cycle. Psychotherapy growth istosupport andchangeinclientsusingthispairingcombination sequence calledtheFive Fundamental Actions (Aposhyan, 1999). The aimof Yoga Based Body the Universal Principles ofAlignment(Friend, 2008),andadevelopmental movement A Yoga BasedandBodyCenteredApproachtoCounseling Cycle, Universal Principles ofAlignment in thefuture andlimitationsconcludethispaper. application are provided. Further considerations exploringwhere this approach might go Interaction Cycle. Yoga Based BodyPsychotherapy isthenexplicatedandexamplesfor outlines of the Universal Principles of Alignment, the Five Fundamental Actions and the yoga therapy, yoga in psychotherapy and yoga in body psychotherapy is offered with viable contentforhealing,growth andchange.Abriefreview oftheliterature covering of a psychotherapy sessionso that eliciting emotional material becomes a potentially of yoga postures by makingtheirinherently therapeuticnature overt inthecontext development ofbody-centered waysofcounseling,andtoafford lensforthepractice anew overtly bringyoga postures intothecontextofbodypsychotherapy further tosupport for counseling calledthe Interaction Cycle. The aim of this approach is twofold: to movement patternknown astheFive Fundamental Actions, withinaframework yoga principlescalledtheUniversal Principles ofAlignmentwiththedevelopmental in clientsby expandingtheirdevelopmental edge. Yoga Based BodyPsychotherapy pairs movement theprocesses ofgrowth patterningtoassess,identifyandsupport andchange high-functioning adultclients. This approach utilizes yoga postures anddevelopmental This paperpresents Yoga Based BodyPsychotherapy, afive-stage approach tocounseling This paperpresents Yoga Based BodyPsychotherapy, apairingofyoga principlescalled Submitted 2December 2012;received inrevised form28February 2013;acceptedMarch 2013 Key words: yoga, developmental movement, Five Fundamental Actions, Interaction Yoga BasedBodyPsychotherapy: Livia Shapiro Abstract of Hatha yoga (Friend, 1998). yoga known for its anatomical principles and emotional process, founded Anusara Yoga, a style movement common to the understanding of yoga postures, and developed a succinct style of drawn towards thelightofsoul” (Iyengar, 3).John Friend, whocapitalized onprinciples of the level ofthevibrant mind,sothatthebodyandhavingbothbecome vibrant,are of yoga helpsustokeepthebodyasatemple…Yogic practiceshelpto develop thebodyto the Universal Spirit”. He goesontosaythatdespitethisseeminglyabstract notion,“the science facilitated Hatha yoga’s development inthewest, describesyoga as“the unionofthesoulwith 1989). B.K.S.Iyengar, oneoftheforemost practitioners, scholars andteachersofyoga who through friction as the muscles and bones work together and in opposing directions (Iyengar, means “to strike”, as in striking a match. The practice of yoga postures literally creates union Yoga isaSanskrit termfrom theroot “yuj” literallymeaning“to yoke” or“to unite”. Hatha friction andheatinthebodymindthrough increasing awareness andphysicalcapacity. Cycle. Actions with the Universal Principles of Alignment within the framework of the Interaction feedback oradjustayoga posture. Yoga Based BodyPsychotherapy pairstheFive Fundamental yoga posture, organize theprogression ofayoga classandinhow ayoga teachermightprovide the Universal Principles ofAlignment(Friend, 1998)inproviding a thesequencetoconstruct Feedback, andProcess (Aposhyan, 2004). These fourstepsare similartotheprogression of over time.Four stepscomprisetheInteraction Cycle; Embodiment, Desire, Awareness and progress inanindividualpsychotherapy sessionaswell asthepathofpsychotherapeutic work developing inpsychotherapy andintheirlives. The Interaction Cycle contextualizes aclient’s patterning andanindividual’s relationship withwhattheywant,thegoalsare interested in 2001). patterning withintheframework ofGestalt therapyasaformofbodypsychotherapy (Frank, by Ruella Frank, whosework, encapsulated insixfundamentalmovements, utilizes earlymotor psychotherapeutic applicationofdevelopmental movement patterninghasalsobeen pioneered application withtheFive Fundamental Actions intheInteraction Cycle (Aposhyan, 2004). The Centering. Aposhyan developed BodyMind hasfurther Centeringintoapsychotherapeutic is strongly influenced by Bonnie Bainbridge Cohen’s work, whichisknown asBody Mind through givingandreceiving insatisfyingways (Aposhyan, 1999). Aposhyan’s work inthisarea Yield, Push, Reach, Grasp, Pull, demonstrateshow humanbeingslearntoengagewiththeworld originsofmovement.early motordevelopment inhumansandtheevolutionary The sequence, a strong framework forholistichealingatthelevels ofbody, mindandspirit. movements ofyoga postures insidethesafetyofrelationship oftherapistandclientprovides transformation. The pairingoftheorganicmovements ofdevelopmental lifeandthecontrolled techniques toassessandtreat psychological distress theprocess ofchangeand andsupport Cycle. with thepsychotherapeutic from theFive support Fundamental Actions andtheInteraction overt withinthecontextofpsychotherapeutic container by utilizingyoga postures paired inherent process ofemotionalandpsychological awareness encouragedinthepracticeofyoga helpful toone’s psychosocial- andspiritualgrowth. Yoga Based BodyPsychotherapy makesthe The practiceofyoga postures known asHatha Yoga isaphysicaldiscipline thatcreates The Interaction Cycle isapsychotherapeutic explorationoftherelationship ofearlymotor The Five Fundamental Actions isadevelopmental motorsequencederived from studiesof Body psychotherapies ofmovement-based useabroad spectrum and body-centered YOGA BASEDBODY PSYCHOTHERAPY 43 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 44 International Body Psychotherapy Journal The Art and Science of Somatic Praxis own theclientisexperiencing. betherapeuticandhealingforthediscomfort (Shapiro, 2007; Walsh, 2008; Vera, 2009). The ideaisthataninclusive yoga practicewillonits often prescribed alongwithbreathing techniquesandmeditationincombinationwithpostures disease, anxiety, depression, andeatingdisorders. In thesecases,aprotocol ofyoga postures is focuses on the use of yoga for physical and psychological conditions including back pain, heart physical andpsychological symptoms(Iyengar, 1989). The current literature on Yoga Therapy thescienceofyoga andsubtleanatomy, ofAyurveda, postures aswell asthetheory toalleviate own asatherapeuticmodalityforphysicalandpsychological issues. Yoga Therapy usesyoga application ofthephilosophyandpractice Yoga”. that This modelasserts Yoga standsonits of empowering individualstoprogress toward improved healthandwellbeing through the in yoga posture practicealone. witness themselves andhealcore emotionalwounds, aphenomenonthatdoesnotoccurovertly theclient’sfor thewitnessingattentionoftherapist,whichsupports abilitytoeventually affects theirsenseofself. The Interaction Cycle incombinationwithyoga postures alsoallows gives clientsmore intentionaloptionstoexplore theirbodyinmotionandtrackhow doingso relational andbehavioraloptionssafely. The practiceofyoga inthepsychotherapeutic context Yoga forexploringnew andcontainment,supportive postures canfacilitateasenseofboundary sequencing mayfacilitateasenseofspontaneity, anaturalexpression, andaqualityoffreedom. a satisfyingrelationship withexpression, motivation, givingandreceiving. Natural movement movement processes insidethestructure andboundariesinherent inyoga postures mayleadto of body psychotherapy’s Interaction Cycle is to offer the possibility that sequencing organic Therefore theintentionofpairingyoga withtheFive Fundamental Actions intheframework therapy withimpairmentintheircapacitiestoexpress themselves orexperiencetheirworld. their movement asitsequencesthrough theirbody. Psychotherapy clientsoftencometo natural movement patterningderives itsbenefit from theprocess oftheclientexperiencing ontheshapeofposture andreceivingclient trying itsbenefitswhereas, ontheotherhand, by privilegingtheinherent intelligenceofthebody. Yoga from derives the itsbenefitinpart joining alludedtoinitsdefinition.Bodypsychotherapy naturalorganicmovement supports as adisciplineutilizes controlled movements, oftenrestrictive innature, tocreate theunion or body and breath into shapes and forms based on energetic lines in the body (Walsh, 2007). Yoga LIVIA SHAPIRO guided imagery, andmindfulness meditation(Fernros, Furhoff, Wandell, 2008). These studies benefits in overall healthofmind-body therapiesincludingbodymovement, breath therapy, Luchter, &Abrams 2007).In 2008astudyby Fernros, Furhoff, and Wandell illustratedthe treatment fordepressed patientstakinganti-depressants (Shapiro, Cook,Davydov, Ottaviani, (Clance & Mitchel, 1980). Astudy in 2007found that yoga has potential as acomplimentary that bodyawareness inchildren andpositive bodyimagewere increased through yoga practice their body strongly influenced their life (Fisher, 1970). Clance and Mitchell showed in 1980 capacity toincrease mind-body awareness. In 1970,Fisher proposed thatone’s perception of Yoga Therapy is defined by the International Association of Yoga Therapists as “the process Hatha yoga hashistoricallyfocusedoncontrolling andinmanywaysmanipulatingone’s Yoga hasagrowing presence duetoits intheliterature asapotentially viableintervention Yoga inPsychotherapy Yoga Therapy the body, ratherthanintheclassical restrictive style. postures movement by inagentleorganicprocess evolutionary supported andthesystemsof psychotherapeutic butitdoesdescribehow applicationorintervention, topracticeyoga movement” (Bainbridge Cohen, 2008, p. 193). This approach does not designate itself as a lens of“…how thebodysystemsanddevelopmental movement andinitiate patternssupport Centering. In thisapproach, yoga practiceaswell asanatomystudyare explored through the Body-Mind Centeringdirectly pairsyoga posture practicewiththeprinciplesofBody-Mind 1993). One oftheappliedprograms offered through BonnieBainbridge Cohen’s Schoolfor (Brammer &Ingram, 2010;Monk, Elizabeth & Turner, Charlie,2010;Khumar, Kaur&Kaur, focuses ontheapplicationofIyengar yoga, analignment-orientedstyle of Hatha yoga The literature inthecontextofpsychotherapy onusingyoga-based interventions primarily specifically, perhapsbecause yoga isoftenconsidered tobeits own body-centered technique. Davis &Hayes, 2010; Walsh &Shapiro, 2006; Christopher&Maris, 2010). (Shapiro, Astin,Bishop & Cordova, 2005;Bruce, Manber, Shapiro &Constantino,2010; yoga, andmeditative disciplinestomitigatethestress impactsofbeinginthehealthcare field point toward thebenefitsofpsychotherapists’ utilizationofmindfulness-basedstress reduction, practitioners in their own self-care regimens to avoid burnout and fatigue. Several studies (Kabat-Zinn, 1996).Currently there isresearch illustratingthatyoga andmeditationsupport was madepopularthrough theMindfulness Meditation movement andJon Kabat-Zinn healing andtherapeuticespeciallyincombinationwithmedicaltreatment andpsychotherapy the clinicianandclient(Davis, Daphne M.&Hayes, Jeffrey, A.,2011).Mindfulness as which inturnimpactothermentalandphysicalhealthproblems (Turner & Turner, 2010). depression viaself-report measures, andindicateditseffectiveness ineasinganxietyandstress 2010 indicatedthatyoga practiceisbeneficialtomentalhealthinits reduction ofanxietyand thenotionthatyoga practiceisindeedtherapeutic. seem tosupport Turner and Turner in the primary goal of Yield. (Aposhyan,the primary 1999). a baby, one rested inthewomb. Receiving inarelaxed support way, butalert withawareness, is impulses. Yield relaxes one’s systemandisthoughttobethestateinwhichas bodyandnervous state ofwakefulness. Yield isfullofengagement,marked andopennesstoreceive by alertness collapse. One themaswell isin contact withtheground astheirinternal,fluid thatsupports growth of the physical capacity of thebody and the social-emotional growth of the whole being. action hasbothaphysicalmovement andapsychological simultaneous quality thatsupports world. They are progressive, eachaction building upontheonebefore (Aposhyan, 1999). Each wounding, orlifesituationsinwhichonelearnsmaladaptive waysto meettheirneedsinthe suchastrauma,earlyattachment myriad waystheseessentialactionsmightbecometruncated, a relationship withtheFive Fundamental Actions: Yield, Push, Reach, Grasp, Pull. There are satisfying relationship withneed,want,expression, givingandreceiving, onemustdevelop Little research existsonthepairingofHatha yoga practiceandbodypsychotherapy Research alsoshows thebenefitsof yoga increating anexperienceofmindfulnessforboth Susan Aposhyan explainsinBody-Mind Psychotherapy (2004)thatinorder tohave a Yield, thefirstaction, refers toadynamicpulsationinthebody, a relaxed state without Yoga Psychotherapy inBody Five Fundamental Actions YOGA BASEDBODY PSYCHOTHERAPY 45 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 46 International Body Psychotherapy Journal The Art and Science of Somatic Praxis healing psychotherapeutic environment. Asteadyyoga practice,asthe literature mentioned presence creates theground forspontaneityandcreativity inthesession.It istheroot ofa as cultivated through self-awareness andpresence. The fullnessofthetherapists’ aliveness and motivated? What isalive?” (2004, 1999,87-8). doestheclientwant?Howgiving andreceiving inthe world.“What andwhere issheorhe Actions explores aclient’s developmental edgeby askingquestionsaround motivation, desire, awareness andboundaries. The Interaction Cycle incombinationwiththeFive Fundamental range ofmotionandflexibilityhighlightgrowing edgesininternalandexternalmovement themselves tounderstandingone’s physicallimitsandboundaries. They challengeone’s bodily edge happensquitenaturallyinthepracticeofyoga postures. The shapesofthepostures lend and behaviorsthatare untried” (Aposhyan, 2004,p. 86). The experienceofthedevelopmental as thelimitofourcurrent abilities,orasthedistinctionbetween behaviorsthatare mastered between ourstrengths andourchallenges…identifiedasaplaceinthebody, ormore behaviorally the Interaction Cycle isaclient’s developmental edge,whichAposhyan explainsas“the border Embodiment, Desire, Awareness andFeedback, andProcess. The psychotherapeutic focusof moment”a particular (Aposhyan, 2004,p. 86). The fourstepsoftheInteraction Cycle are awareness ofhow clients’ developmental processes are manifestingintheclients’ bodiesat strength,effort, andwillpower. choice (Aposhyan, 1999). It is how one learns one is capable of getting what one wants with dynamic and co-participatory. Pull brings the outside world into one’s personal world out of Iteffort. helpstofacilitate thedynamicrelationship between selfandtheworldoutsideas personal kinesphere. Pull ishow one’s needsanddesires ultimatelygetmetwithone’s own one cantakeholdofwhatwantsorneeds(Aposhyan, 1990). with theoutsideworldandtakeintoward oneself. Through thisaction,onelearns one’s desired stimuluswiththeirendpointssuchashandsorfeet. To Grasp istoriskengaging one’s capacitytoholdontoandtakeinwhatonewants. This actionrequires onetograbholdof follows. Grasp is the stage in which one takes hold of what one wants. This action facilitates for interconnectedness. oneself beyond one’s personalkinesphere intoone’s interpersonalfieldwhere there ispotential of thebodyouttoextremities (Aposhyan, 1990).It provides thecapacityforonetoextend toward whatonewantsandactingonknows Reach tobetrue. extendsfrom thecore one extendsouttoward astimuluswiththetonecreated from Push. Reach isaboutmoving backdrop forgoingoutandtakingactionintheworld(Aposhyan, 1999). the extremities andthecore ofthebody. It aswell asorganizingandprovides isinitiatory the tone inthebody. The musclesofthebodycreate dynamicoscillationbetween toneandsupport press down intotheground, whichrebounds asacounter-pushrisingupthespine,providing reflects theclient’s orientationtoward theirmotivating source. Theactionofthebodyisto LIVIA SHAPIRO The firststep, Embodiment, focusesontherapists’ grounded relationship tothemselves Grasp isfollowed by theaction,Pull, inwhichthedesired stimulusispulledintoone’s Once Reach action,Grasp, hasextendedthoroughly tograbholdofthestimulus,fourth Push andstrong enoughforthethird makesthebodytoned,alert action,Reach. In Reach, The secondaction,Push, organizes themusclesofbodytoward movement andoften The Interaction Cycle is“a four-stepcycle thatjoinsbothclients’ andtherapists’ Interaction Cycle The universal Principles ofAlignment,then, are liberation, integration, designedtosupport the actualmovement required ofyoga postures, butthecapacitytofullyexperience one’s life. addition, it is assumedthat one may have already experienced trauma that hinders not only their bodiesandmindsalready contracted,orprohibited inmovement andself-awareness. In Muscle Energy, Inner Spiral, Outer Spiral, andOrganic Energy. in thattheyare adevelopmental sequenceofmovement patterns. They are: Open toGrace, 2008). The Universal Principles ofAlignmentactmuchliketheFive Fundamental Actions psychological oremotionaleffectinsidethebodyandexperienceofyoga posture (Friend, ofeachyogabody thathelpstoorganize posture boththeouterconstruction aswell ascreate a deep roots inIyengar yoga. Each oftheseprincipleshasaphysicalexpression asanaction inthe rangeofmotionandemotion,physiologicallypsychologically.a new the clientmeetshis/herDevelopmental Edge, where patternedways ofmoving expandtoward through gentlefeedbackandsuggestionsastheclientmoves (Aposhyan, 2004).In sodoing, pelvis andfeet,sothatacompletesequenceofmovement isexperienced. This isfacilitated movement intheclient’s bodytoexpress fullythrough his/herendpoints,mouth,hands,heart, structure from the therapist in guiding his/her emerging experience. the The therapist supports physical andemotionalprocess withthehelpoftherapist. by gentle The clientissupported level. where a client is in relationship to his/her desire and his/her developmental edge at a somatic by practicingaposture thatilluminatesthedeveloping edge. This mayofferunderstandingof postures specifictoeachactionandstepfullyexplore how desire acertain feelsinone’s body for thepracticeofyoga postures insession. Yoga Based BodyPsychotherapy contributesyoga kind offeedbackcanbeutilized notonlyfororganicnaturalmovement sequencesbutalso options, through beingdescriptive, orby offeringaninterpretation (Aposhyan, 2004). This Feedback by thetherapistasanopen-endedquestion,afocusedwithinmenuof appears inthebodyormoves withinthebodyare broad. Feedback isoffered inAwareness and into abodily-understoodreality. usedtoexplore whereThe interventions andhow desire her (Aposhyan, 2004). is, orhow longithasbeenburiedinsidehim/her, orthereasons around whatislimitinghim/ her desire andmotivation, his/hervulnerability increases ashe/shecomestoseehow realistic it understand his/herrelationship tothatdesire. Aposhyan notesthatwhenaclientidentifieshis/ in reference tohim/herself. Ashe/sheunderstands his/her desire ormotivation, he/shebeginsto Edge. Asaclientbuildshis/hersenseofembodiment,he/shelearnswhere he/sheisinspaceand When aclientidentifieshis/herdesire, he/sheaccessesunderstandingofhis/her Developmental yoga session. (Aposhyan, 2004). This kindofcenteringinawareness maylooksimilartothebeginningofa awareness withinthesessionby noticingandidentifyingsensationsortakingdeepbreaths above illustrates,facilitatesthetherapist’s Embodiment. The clientfocusesonincreasing As aresult ofbeinginphysical bodies,Anusaraprinciplesposit,humanbeingsarrive in The Universal Principles ofAlignment(Friend, 2008),encapsulatedinAnusara Yoga have step,The fourth Process, askstheclienttostaywithawareness andsensationsofhis/her The third step, Awareness andFeedback, focusesonmakingtheclient’s identifieddesire The secondstep, Desire, focusesonunderstandingtheclient’s wantsandmotivations. Universal Principles of Alignment YOGA BASEDBODY PSYCHOTHERAPY 47 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 48 International Body Psychotherapy Journal The Art and Science of Somatic Praxis turns theyoga posture intoanemanation—a non-verbal gesture ofinternalexperience. foronetomake anofferingfrom oneself outintoone’sthe opportunity world.Outer Spiral intended to be asatisfyingcompletiontotheyoga posture, as well as to afford awareness and fosters asenseofbeingoneself intheworldwithoutpretense orapology. Organic Energy is endpoints suchasthehands, feet,headandtailbone(Friend, 2008). Organic Energy extend fullyindynamicbalance from thecore outthrough peripheralextremities and becoming oneselfintheworld. one’s desires anduniquewaysof being.Outer Spiral setsthe stagefordifferentiating and one toroot notonlyintothepower of one’s own but intoone’s effort, own knowing—into of purposeanddetermination,facilitateswillpower decision-making.It andsupports allows tones, preparing foroutward directionality orextension.Outer Spiral increases one’s sense (Friend, 2008). The energy of one’s body is directed down and out as one’s whole body the lower inthespineiscreated bellylifts,thetailbonelengthens,andatonetocurve body toone’s feet,counteringandcomplimentingInner Spiral. The waistlinecontracts, accommodate oneselfandothers. Inner Spiral is connected to both one’s creative nature in the world and learning how to also asenseofreceptivity, sensuality andaccesstocreativity associatedwiththisphase. system(Friend,psoas musclesaswell, whichtendstocalmthenervous 2008). There is out. The rooting ofthethighsbackward intoone’s bodyfacilitatesthealignmentof of deepening,asenseaccommodation,widthandbreadth from theinside external legrotation thathumanbeingsdevelop by walking. Inner Spiral creates a sense turns one’s innerthighsslightlyinward commonover- andwidetocounteractthevery side broadening action(Friend, 2008).Inner Spiral moves one’s thighsbackwards and at thefeetandrisesuplegstorso,expandingwidthofbodyinaside-to- containment andinnerstabilityforthemindemotions. one’s endpointstoone’s core. The stabilityofthebonesandmusclesafford asenseof literally becomesstronger andmore integratedasone’s musclesengageandpullinfrom action yieldsthepsychological benefitofwillpower, purposeandstrength. One’s body are increased asoneliterallyengagesoneselfintoactiontoproduce aresult. Self-chosen also toone’s mindandemotions(Friend, 2008).Feelings ofaninternallocuscontrol the body. Muscle Energy gives power andpurposenotonlytothemusclesbonesbut Open toGrace comessteadymusclepower thatcreates theorganization toward actionin physically, energeticallyandemotionally. From therooted, grounded andopenplaceof emanatingfrom it.ease andcomfort one ispresent, feltenergeticallyaswell as seen visiblyintheone’s posture whenthere is allowing asahumanbeingintheworld.It forsupport shows upasthequalitywithwhich welcoming ofpossibility, changeandgrowth. Open toGrace isaboutreceiving, beingand system.Itnervous creates aspaceinwhichtopracticeyoga and thatisopenyet alert system (Friend, 2008). This isintendedtobephysicallysettlinganddeactivating forthe one’s skin,feelstheweight ofone’s bonesandreleases tensioninone’s musculoskeletal to Grace isthefirststageofopeningandgrounding. During Open To Grace, onesoftens transformation andexperienceoflivingintoone’s fullestpotential. Toward thatgoal,Open LIVIA SHAPIRO Organic Energy is the final Universal Principle ofAlignment. Thebones ofone’s body The fourth stage,Outer Spiral,The fourth energeticallymoves from one’s waistlinedown the The third stage,Inner Spiral, widensthebodyfrom thecenteroutward. It begins Muscle Energy isthesecondstage,centered ongatheringstrength andpower participate in defining viable content, goalsand motivationsparticipate for therapeutic work. The session and Feedback. Adecisive qualitycharacterizes Experience inwhichtheclientandtherapist co- Experience and emotionaswell asanextensioninto thetherapeuticrelationship. boundaries have already beenset.In thisway, there isareaching orstretching intoexperience here that potential core material might be accessed as the foundation of grounding and safe reaches intohimselforherself. Asexperienceisshared, emotionsmaybegintoexpand.It is as thesessionprogresses. In essence,thetherapistreaches toward theclient,whileclient the client’s Desire. This stagemarks where thetherapistgathersinformationfrom theclient Form she isinsidehim/herselfandwhathe/shewantsinrelationship tohis/herworld. notion ofdevelopmental edge.It istheplaceandspaceinwhichaclient beginstoseewhere he/ exploring his/herwantsandmotivations, likewith thestepofDesire. Initiate introduces the productive therapeuticrelationship. placeforaclienttobegin This stageisthepreparatory Initiate also sets a sense of boundaries between therapist and client, which cultivates a safe and thebodytocreatesupport specificactions neededtodothe yoga postures andbasicactions. tone ofthemuscles.Ideally themusclesare toned,nottootight,loose,inorder to to maketheshapeofayoga posture. Initiate isfeltinthebodythrough cultivating proper and Push andisthewayinwhichaclient’s bodyorientstoengagehis/hermusclesandbones therapeutic relationship, thetherapysession,andinclient.Initiate joinsMuscle Energy Initiate sessions aswell asthefirstmomentinwhicha yoga posture ispracticed. allowing him/herselftoarrive inhis/herbody. This issimilartothebeginningofmostyoga to themselves. The clientisencouragedin Sense tofeelhis/herskinandnoticebreathing, which theclientandtherapistattunetooneanother;itisstageinclientsfirst helps theclientground by beingpresent inhisorherown body. Sense isnotonlythestagein the clientandisopentoexperienceofboththemselves. In Sense, thetherapist andofthearc oftherapy.intervention The therapistisfirsthighlyspaciousinorder to receive like thestepofEmbodiment, Sense istheinitialstageofasession,assessment,andany Open to Grace and Yielding in the context of a psychotherapy session that utilizes yoga. Much Sense therapy mayalsobeviewed asfollowing thesequenceover time. also bepracticedindividually. Atherapistmayspendentire sessionsinonestage,andthearc of these stagesfittogethersequentiallyandcan resolve inthecourseofonesession,eachstagemay and The fourth stage, Experience, pairsOuterThe fourth Spiral andGrasp inthecontextofAwareness The third stage,Form The secondstage,Initiate embodimentandcreates supports containmentinthe , further Sense centralizes onactive receptivity withinbothclientandtherapist. This stagecombines Yoga Based BodyPsychotherapy utilizes aseriesoffive stages,Sense, Initiate, Form, Experience Receive, conceptualized withinthebroad frameworkoftheInteraction Cycle. Although , combinesInner Spiral andReach withinthecontextofdeciphering Yoga Based Psychotherapy Body YOGA BASEDBODY PSYCHOTHERAPY 49 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 50 International Body Psychotherapy Journal The Art and Science of Somatic Praxis becomes akindofoffering,infusedwiththeclient’s emotionalcontent. experience. Integration andinsightare oftenvisiblein a yoga posture whentheposture itself requiredsustained effort inayoga posture helpsaclientlearnhow tostayinhis/heremotional posture mirrors thedynamicunderstanding of oneselfinrelationship toselfandother. The of yoga postures andbasicactions. The equalgivingandreceiving ofdynamicactioninayoga come viafeedbackfrom thetherapist,orthrough theclient’s experienceoftheirown practice how the awareness their own and witness of the client supports insight. This awareness can on theintegrationofpsychotherapeutic material,experience,andawareness. Receive denotes the Process step of the Interaction Cycle, Receive experience, andworking through experienceispresent inthisstage. to navigatethedevelopmental edge.Afocusedattentionondelineatingexperience,clarifying to stay with the posture, information regarding to collect new the immediate experience and immediate experience. This stageteststheclient’s capacitytostaywithwhatishappening, doing a yoga posture restingor basic action. Experience supports into a yoga posture and the pelvis, feet)oftheclient’s body. This helpstoroot thetailbonetoward empowered actionwhen quality of either outward or inward direction through the endpoints (mouth, hands, heart, is atoningandintegratingofthebodymuchlikeInitiate, except now withagreater directional momentumandthetherapistclientarehas acertain inco-creation. In thebody, Experience LIVIA SHAPIRO requiring settling in apassive manner toafford health.Supine postures requiring Yamit’s legs in theirfeet.“Yamit appeared postures system.Iutilized rigidandinher sympathetic nervous the clienttopractice stayingpresent and engagedintheirbodyand yet relaxed andeaseful standing posesseemedtoprovide anunderstanding ofSense and wakefulnessoutside.Using dynamic standingpostures includinglunges andsymmetrical the innerorouterstructures oftheirbody. Rather, adynamicaliveness insideyieldsreceptiveness thatSense activemobilized waywithXavier tohelphimlearn isnotacollapseorabdicationof in hisstancewithadominant parasympathetic systemresponse. nervous Ipracticed Sense ina embodiment. themselves andbetween eachother. This ishow thesessionitselfbeginstodevelop its the Five Fundamental Actions asbothclientandtherapistfeelthepresent momentinside thecontext of psychotherapy.support Sense is the ultimate example of Yield as itstands in of mindfulness indicates, grounding and embodiment techniques are therapeutic and stage asks,“CanIsettleintothismoment?How doIfeelinthismoment?” Astheliterature felt, identifiedandunderstood—thisisthemainpsychotherapeutic theme ofSense. This Sense the Interaction Cycle asapsychotherapeutic approach. use with these clients in each stage of Yoga Based Body Psychotherapy and their relationship to issues tendingtooccurinhigh-functioningadultclients.Specific yoga postures are outlinedfor The fifthstage,Receive, pairsOrganic Energy andPull insidetheframework ofProcess. Like Sense appeared canbepracticedinbothactive andpassive postures. more “Xavier passive Deepening one’s embodimentistheground from whichdesire andmotivation canbe The following applicationincludesbriefcaseexampleswithgeneralthemesandclinical Application Receive in Yoga Based Body Psychotherapy focuses as active.” These posesrequire allowing themselves tohave adesire atall. body intheyoga posture; ityields thecapacitytoaccessForm of reaching from theinsideout toextendthemselves isbeneficialnotonlyfor stretching their extending outfrom his/hercenterintoworld.Inviting clientstopracticethisquality bends, can lendanunderstanding similar to Reachsuch as in forward in which the client is broaden aclient’s awareness emotionalcontent. and surface Widening theback ofthebody, expanding laterallyaswell asmoving backward. This expansionissimilartoReach andcan are moving backandwide,their low andtheirwaistlineis backisdeepening intoitscurve opening. These postures alsorequire actionssimilartoInner Spiral inwhichtheirthighs standing postures andwide-leggedseatedpostures require the maintenanceofthiskind in thepelvisandlegsare relatively simpleinconstruction. Wide-legged symmetrical to thewaysherelates toherpartner.” fusion Beth haswithherpartner. Beth reported thatherrelationship toheryoga postures issimilar Beth indoingheryoga postures withopennessinorder tofacilitatetherealization ofthedepth theyogathe bodyfrom posture theinsideout andconstruct into itsbasicform.“Isupported intended tohelptheclientembodyidentificationofhis/her desire by helpinghim/heropen may wantahealthierrelationship withhis/herpartner. The useofyoga postures inForm relationship tothatdesire. In thehigh-functioning adultworking onrelationships, theclient identifies his/herdesire ormotivation andbegins tounderstandhis/herdevelopmental edgein Form progress inAlan’s process ofdifferentiation andcultivation ofsenseselfinpracticing thesepostures.” strength, andasymmetricalstanding posestofosterhow hecouldpotentiallyengagehimself.Ifound inhisposturesthrough hislegs, as observed thusfar. single-leg balancing postures Iutilized tobuild the holdingofmultipleperspectives inlife.Alan alsohasdifficultyengaginghismusclesandpushing postures Alan’s legswork together, butnotinthesameamount. Thus thecomplexityofactionmirrors neededindifferentunderstanding ofthemuscularengagementandself-assertion degrees. In these “Alan hasatendencytofusewithothers.Iusedasymmetricalstandingpostures an tosupport This cancultivate theunderstandingofhow muchengagementtheymightneedinrelationship. forayoga posture bynecessary engagingMuscle Energy orpracticingthebasicactionPush. therightamountofengagementintheirbody The high-functioningadultclientcanascertain are often learning how to have productive and positive relationships with both self and other. exploring theirDevelopmental Edge regarding differentiation. Clientsworking onthisgoal source. This physicallycreates thecontainerforknowing clearlywhattheclientdesires. understanding ofboundariesandbeginstodelineatedevelopmental edgeatitsmostbasic postures asameanstoidentifyselfandinrelationship tootheraffords agreater embodied and work toward whatmotivates them.Practicing Muscle Energy andPush through yoga identifying the client’s desire as it helps cultivate the container for him/her to safely identify Initiate activation ofthemusclesorover- gripwhen theyengagetheirmuscles. theclientmaybetoolooseinhis/herbodytocreatekind ofgrounding andsupport, strong to beactive granted oftheground.” understandingofsofteningintothesupport this Without Postures where the client’s legsare wideandtheirhipscanmove freely allow natural opening Form When working withhigh-functioningadults,oneofthekeygoalsintherapyoftenis Initiate amIinrelation asks,“Where tomyselfandothers?”Initiate isthebeginningof asks, “What doI want andhow amIin relationship asks,“What to it?” Here theclientclearly YOGA BASEDBODY PSYCHOTHERAPY in life,whichmay beassimple are 51 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 52 International Body Psychotherapy Journal The Art and Science of Somatic Praxis wave ofSense—whether itisinanotheryoga posture, oranothersession altogether. expression ontheclient’s face. The fullcompletionofthisstagemoves rightbackintoanother that canbenotedinthefullexpression ofhandsandfeet,fingerstoesthequality ofthe posture. his/her developmental edge,justlikeOrganic Energy offersthefinalexpression ofa yoga relationship tohis/herdesire tobeinahealthyrelationship. The clientisessentiallyexpanding and expression potentiallycreate radicalchangein how theclientexperiences him/herselfin movement and Carry’s emotion fully sequence through her whole system.” This kind of full extension her endpoints in her postures. This appeared to engage the rest of her limbs more fully. I observed toexploreher developmental edge.IinvitedCarry extendingandexpressing herselffullythrough a lackoffullysequencedembodimentinCarry’s identified desire withintherapy. Thisseemstobe andlegsin herpostures.and feetlimpassheextendsherarms Iwondered ifthiscouldindicate how vital their needs in relationship Carry’s actually are. to their partner “I observed hands of energytomove inawaythatismore satisfyingandfluid. extendingmoresupports energythrough thearmandcreates fortheexpression anopportunity posture andpointhis/herfingersinaclearlinefrom shoulder, through arm,towrist,andout in one’s waysofbeinginrelationship bodyandnew intheworld.Coachingaclienttodoyoga takes toholdaposture ittakestostretch kindsofmovement isthediscomfort intonew patterns mouth andpelvis.It iswhere thedevelopmental edgeistestedandexpanded. it The discomfort life. a posture isexecuted increases ordecreases thecapacityofReceive bothinayoga poseandin Receiving component inherent inGrasp andOuter Spiral. often stimulatingemotionalrelease aswell asbringing upfear, whichissimilartotheemotional be inrelationship toselfandother simultaneously.” region, Thebackbendsalsoopentheheart Wendy’s sense of self rather than an abandonment of herself. This seemed to teach Wendy that she can developing appropriate tailboneactionsothebackbendsbecameanexpression andexperienceof I findthissimilartoanunderdeveloped Grasp inthe Five Fundamental Actions. We worked on her backbendsinsuchawaythatlow backisexploitedinover flexibilityandaccommodation. strength, presence, andsenseofself. “Wendy haslittleself-identity. Ihave observed Wendy do is misalignment.Rooting through one’s tailboneinanactive anddecisive waycultivates inner feet, thelower asimmediatefeedbackthatthere backwillcompress andcausepain,serving goal. executes aposture, he/shecomestofindhow closeorfarawayhe/sheisfrom his/herdesire or motivates him/hereven whenchallengedby theoutershapeofaposture orlife.Astheclient of theclient’s tailbonefacilitateExperience andteachingaclienttostandupforwhatitisthat Experience LIVIA SHAPIRO natural movement pattering, and iscomplexinthatthe therapist mustlearnwhichyoga With high-functioning adults, it may be that in sustaining the posture they come to realize Receive Often inbackbending,forexample,ifthetailboneisnotextendeddown toward the am I in relationshipThis stage asks, “Where to my desire?” Postures accessing movement Yoga Based BodyPsychotherapy issimpleinitsfollowing ofadevelopmental order like Receive isincreased whenattentionisbrought totheendpointsofhands,fingers,feet,toes, Receive asks, “Can I be fully in relationship with my desire? Can my desire be met?” The way has anenergeticqualityofsatisfactionfoundinPull andinOrganic energy Further ConsiderationsandLimitations Email: [email protected]: www.ecstaticunfoldment.com. and LeahD’Abate from Naropa University the writingofthispaper. supported their continual emerging processes.their teaching skills and support Christine Caldwell programs elementsofbodypsychotherapy foryoga teachersaboutimportant toimprove teaching yoga since2004.She works primarilyteachingyoga andproviding educational in Somatic CounselingPsychology. She hasextensive traininginHatha Yoga andhasbeen Livia Shapiro isgraduating from Naropa University inMay of2013withamaster’s degree BIOGRAPHY and diseaseinmoderntimes. psychotherapy are contributingtoandexpandingthewayswe conceptualize health ofarichandgrowingThis paperispart conversation inwhichbothyoga andbody toexplore withclients,thusbroadening intervention thescopeoffield.structural context provides bodypsychotherapy withanothermodeofmovement analysisand authentic, natural way. Introducing yoga postures overtly into the psychotherapeutic tohealingpsychologicalnature ofyogadistress practicesothatitcanbeinservice inan approach oftheInteraction Cycle invitesmore organicityintothehighlystructured change andtransformation. to support The pairing within the psychotherapeutic psychotherapy and Hatha yoga practice as understood by skilled teachers and scholars inthemarriageofnaturalmovementopportunity patterningasunderstoodby body fortheassessmentandtreatment ofpsychologicalinterventions distress. There isample and understanding. Similarly, body psychotherapy concepts and is pioneering new modern configurationplayasignificantrole inthedevelopment ofmind-bodyholism experiencing extreme states. better-suited tofacilitatingthegrowth ofahealthywitnessfunctioninclients There maybeothermethodsofpsychotherapy thatinvolve mindfulnesstechniques dependent on the capacity for the individual client to grow in his/her witness capacity. therapist tooffertheclient.Furthermore, Yoga Based BodyPsychotherapy issomewhat mirroring capacityfortheclients, meaningthatverbal feedbackwouldbetheprimary the earlierphasesofsequence. Touch mayalsobechallengingforsomeofthese clients withsevere trauma. Thus themajorityoftimewillmostlikelybespentin most likelymove more slowly over thecourseoftherapy. severe characteroligcal issues.However, themethodmightlookdifferent inthatitwould such aspsychosis, experiencingactive symptomsofpost-traumaticstress disorder, or is nottosay Yoga Based BodyPsychotherapy isinappropriate forclientsinextreme states client move inyoga postures feedback. aswell asbeabletoarticulate necessary. The clinicianshouldalsobeabletoassessmovement a patternsby observing various yoga posesasappliedtotheunderstandingofnaturalmovement patterningis the sameskillsneededforonetoteachyoga. Askillsetincludingtheappropriateness of in bothbodypsychotherapy andyoga. This kindoftrainingmaynotnecessarilyrequire postures stages.In lendthemselves toparticular this waytheclinicianrequires training The teachingsandpracticeofHatha yoga, thoughancient inmanyways,their The movements required toexecute yoga postures willperhapseasilyactivate The applicationprovided inthispaperisbasedonthehigh-functioning client. This Conclusion YOGA BASEDBODY PSYCHOTHERAPY 53 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 54 International Body Psychotherapy Journal The Art and Science of Somatic Praxis Shapiro, David., Cook,Ian A.,Davydov, M.,Ottaviani, Cristina., Dmirty Leuchter, Schure, M.,Christopher, J.,&Christopher, S.(2008).Mind-body of medicineandtheart Shapiro, Shauna L.,Astin,John A.,Bishop, ScottR.&Cordova, Matthew. (2005). Milligan, C.(2006). Yoga forStress Management Program asaComplementary programes. Lohman, R.(1999). Yoga andalcoholrehabilitation techniquesapplicablewithindrug Applied, 143(4),390-404. Kraemer, J.M.andMarquez, D.X.(2009).Psychosocial correlates and outcomesof Kabat-Zinn, Jon. (1991).Full catastrophe living:usingthewisdomofyour bodyand Iyengar, B.K.(1989).TheTreeof Yoga . Boston:Shambhala. Friend, John. (2008).Anusara Yoga Teacher TrainingManual. Psychotherapy. Frank, Ruella. (2001).BodyofAwareness: ASomaticandDevelopmental Approach to Fernros, Lotta.,Furhoff, Anna-Karina.,Wandell, Per E.(2008).Improving qualityoflife Davis, Daphne M.&Hayes, Jeffrey, A.(2011). A What are thebenefitsofmindfulness? Christopher, John Chambers.&Maris, Judy A.(2010)Integrating mindfulnessasself- Christopher, J.,Christopher, S.,Dunnagan, T., &Schure, M.(2006). Teaching Self-Care Bruce, Noah G., Manber, Rachel.,Shapiro, Shauna L.&Constantino,Michael, J.(2010). Bainbridge Cohen,Bonnie.(2008).Sensing, Feeling, andAction: The Experiential Aposhyan, Susan. (1999).Natural Intelligence: BodyMind Integration andHuman Aposhyan, Susan. 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Reprints andpermissions [email protected] Volume 12,Number 1,2013pp56-73Printing ISSNNumber 2169-4745Online ISSN2168-1279 International BodyPsychotherapy Journal TheArt andScienceofSomaticPraxis DEBRA GREENE,PhD empower clientsthrough self-awareness, educationandself-responsibility. in somatics,Iamprimarilyconcerned withpracticalapplicationsofenergymedicinethat people’s bodies,Iwanttomentionthat,asan energy medicineclinicianwithabackground energy work ingeneral tendstoconjure upimagesof“healers” wavingtheirhandsover may contributetobodypsychotherapy between thetwo. andenhance theinterface Since woven intothe fabricofbodypsychotherapy. Energetics (1990),withothersinbetween, thethread ofhumanenergy canbefound energy (1942/1973,1948/1973),toLowen’s Bioenergetics (1975)andPierrakos’ Core in particular, reflects this.From foundationsgrounded inReich’s work withorgone Along theselinesIwouldsaythatallpsychotherapy isenergywork. Bodypsychotherapy, energy medicine,Oschman stated,“All medicineisenergymedicine” (2003,p. 14). and pragmatic. In his rigorous contributions toward paradigm of establishing a new potential forcreating aunifiedbridgefrom thespiritualandscientifictophysical is inexistence--includingus. withenergy,effervescing aquantumfroth. thatThis energyisomnipresent ineverything “empty space”, physicists determined that it was notso empty after all. It was teeming, thatareparticles comprisedofmostlyempty space.In turn, whentheylookedintothe what we are made of, they discovered that matter is not solid. It consists of subatomic and energyintomatter. Indeed, whenphysicistsprobed deeplyintomattertofind interchangeable, different formsofthesame thing.Matter intoenergy canbeconverted homeodynamics, ethericbody senses--areas ofoverlap andapplicationtobodypsychotherapy are discussed. power supply, thereplica effect,andtheinternal effect,theblueprintinterface point.Focusingmedicine, isusedasastarting onfive principlesoftheethericbody—the relevance tobodypsychotherapy. The multidimensionalmodel,akeymodelinenergy This paperpresents a model and concepts from energy medicine and explores their According toEinstein’s famousformula,E=MC This paperintroduces amodelandkeyconcepts from energymedicinethatIbelieve Energy isthecommondenominatoruniting allaspectsoflife.Assuch,itholds Submitted 3November 2012;received inrevised form28February 2013;acceptedMarch 2013 Key words: energy medicine, multidimensional model, subtle energy bodies, medicine,multidimensionalmodel,subtleenergy words: energy Exploring ContributionsfromEnergyMedicine Expanding theDialogue: Debra Greene,PhD Abstract 2 , energyandmatterare being—our fourmainenergybodies—are formed. overlapping frequency domains,orchannelsofexperience,uponwhich thelayers ofour emotional, mental,andspiritual. These fourplanes ofexistencecomprisedistinctyet following Tiller’s lead(Tiller, 1997),Icondensethesetofour:thephysical/etheric, energy frequencies. Early depictions of the model describe seven dimensions, however, Subtle Energy Bodies indicated.unless otherwise for thepurposesofthispaperIamdrawingfrom thework oftheaforementioned authors book on energyhealth(Greene, 2009). When referring to the multidimensional model his groundbreaking work onenergykinesiology, andImadeuseofthemodelinmyrecent energy medicinetextbookofitskind.CharlesKrebs, Ph.D., (1998)alsousedthemodelin researched andbackedby thescienceofday, thebookessentiallycomprisedfirst M.D., in his seminal contribution, human consciousnessinteractswithphysicalreality. his approach, calledpsychoenergetic, hehasmadesignificantstridesin science revealing how various subtledomainsofinnerreality andthedomainofspirit(Tiller, 2013). Through mission istobuildareliable bridgethatseamlesslyjoinsconventional sciencewiththe at Stanford University and former chair of the materials science department. Tiller’s stated his contributionstoenergymedicine.After34years inacademia,heisprofessor emeritus because ofhisbackground inconventional scienceandduetothedepthbreadth of Dibble &Fandel, 2005; Tiller, 2007). Tiller’s are contributionsinparticular significant legitimacy (Oschman, 2000,2003;Rubik, 2002;Swanson, 2010; Tiller, 1997; Tiller, experiences together. dimensions ofreality, whileconsciousnessisthemediatorthatholdsbodiesandour Our energybodiesconstitutethe“equipment” through whichwe experiencethevarious originate atthelevel ofenergyandconsciousnessplayoutthrough ourphysicality. and actionsdonotoriginateinthebrainorelsewhere inourphysicality;insteadthey According tothesemultidimensionalmodels,energyisprimary. Our thoughts,emotions 1978/1985; Leadbeater, 1902/1969;Saraydarian, 1981; Yogananda, 1946/1998). our vehicles ofexperience,ourenergybodies(Bailey, 1922,1951,1953/1971;Jurriaanse, occupy multipleplanesofexistencesimultaneouslyandthatupontheseare formed have beenaround forthousandsofyears inEasternphilosophies. They holdthathumans According of tothemultidimensionalmodelhumanbeingconsistsofaspectrum Rich inheuristicvalue, Tiller’s multidimensionalmodelwasusedby Richard Gerber, This agelessunderstandingofthehumanenergyconstitutionisgainingscientific Energy-based models of human functioning that recognize various dimensions of reality The Multidimensional Model Vibrational Medicine (1988/1996;2000).Meticulously EXPANDING THEDIALOGUE 57 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 58 International Body Psychotherapy Journal The Art and Science of Somatic Praxis DEBRA GREENE,PhD physical body. But the physicalbodyneedsapower supplyinorder tofunction.It needsalife- of the system and brain, all fall within the purview Bones, organs,tissues, blood, glands, nervous plane andwe ofthefactthatwe occupy thischannelofexperience by have virtue aphysicalbody. affected, asisthequalityoflife in general. live ourlives tothefullest. When anyaspectofoursystem isoutofbalance,theentire systemis multidimensional systemisaligned andcoherent we experience radianthealthandare ableto interactions; theouterphysical bodyreflects ourinnerthoughtsandemotions. When our these multipleplanesofexistencesimultaneously, complex. makinguswonderfully which is the highestorfastestfrequency, allows us to have spiritual experiences. We humans occupy and feelingswhilethedomainofmentalbodyisthought and cognition. The spiritualbody, the emotionalandmentalbodiesrespectively. The emotionalbodyisresponsible forouremotions valuable thanlower. The gradationsinbetween thephysical/ethericandspiritual bodiesconsistof a musicalscale. They are notmeantasavalued hierarchy anddonotindicatethathigher ismore seem hierarchical, thesetermsare merely usedtodescribepositions,suchashighCandlow Con end ofthecontinuumandspiritualbodyathigherend. Althoughsuchdesignationsmay The slowest orlowest frequency domainofthehumanenergyconstitutionis physical According tothemodel, ourinner, subjective statesdetermineouroverall healthand The energybodiesrangefrom low tohighfrequency, withthephysical/ethericbody atthelower

the planesofexistence The fourmajorchannelsofexperience,alsosometimescalled are formeduponthosechannels. Channel Physical Channel Emotional Channel Spiritual Channel Mental the Four MainChannelsofExperience The HumanEnergyConstitutionand , andthefourmainenergybodiesthat tei Body Etheric Physical Body Emotional Spiritual Mental Body Body Body Ayurveda, Ayurveda, Tibetan medicine,andkahunahealing,tonameafew. based onthisenergy, asare thehealing systemsof Traditional Chinese Medicine, acupuncture, well anddeveloped theirpracticesaccordingly. from avariety arts ofculturesThe martial are prana in India, or 1972). It consistsof avitality-richenergythatgoesby several names,chiinChina,ki physical bodyisbuilt(Lansdowne, 1986;Leadbeater1927/1997;Powell, 1925/1997; Tansely, helps explainhow theethericbodygotmissedinconventional Western medicine(Greene, 2009). is acadaver. The factthat Western medicalsciencedeveloped primarilythrough thestudyofcadavers etheric istypicallyreferred toasonebodyinsteadoftwo. Without theethericbodyphysical woven together, astwosidesofthesamecoin,whendealingwithalivingperson. Thus, thephysical/ paper Iusethetermethericbody. by various names, i.e.,thevitalbody, the biofield, theconjugatephysical. For thepurposesof this force toanimateitorelseisnothingbutacorpse.In energymedicinethisbodyiscalled The etheric body is the inner substantial form, the invisible scaffolding, upon which the The ethericbodyistheinnersubstantialform,invisiblescaffolding,uponwhich According tothemodel,physicalbodyandethericare understoodasinseparably mental, andspiritualbodies. layers: thephysical/etheric,emotional, The humanenergyconstitutionwithfour mana inHawaii (Greene, 2009; Rubik, 2002). thisenergy The ancients knew mental, anduniversalbodies. layers: thephysical/etheric,emotional, The humanenergyconstitutionwithfour Physical/Etheric Body EXPANDING THEDIALOGUE Emotional Body Mental Body Spiritual Body in Japan, 59 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 60 International Body Psychotherapy Journal The Art and Science of Somatic Praxis anatomy isformed. combining theircontributionsacomprehensive anddetailedpicture ofhumanenergy from cultures dedicatedtocomplexandsystematicstudyoftheethericbody. When yoga, Many acupuncture, arts. ofthesepracticesemerged meditation,andthemartial embraced itsancientmethods. We don’t have tolookfartodayseethepopularity of in theU.S.have beenresistant torecognizing theethericbody, mainstream culture has increasingly validated by Western scientificmethods.Althoughmedicalprofessionals of longago,uponwhichentire successfulmedicalsystemswere built,are being this paper to describe the etheric body in any detail. Suffice it to say that the discoveries of years to studying and working directly with these energies. It is beyond the scope of energy anatomyisfoundinhealthsystemsfrom cultures that have devoted thousands of Reich’s descriptionsoftheorgoneandenergy. However, acompletescienceof energy dynamicsinbodypsychotherapy. from theperspective ofenergymedicinecanbroaden anddeepenourunderstandingof energy medicinethatisgainingscientificlegitimacy. Assuch,understandingthisbody in homeodynamics(Rubik, 2002). The ethericbodyisafoundationalcomponentof life processes onmultiplelevels across various timescalestocreate dynamicstability. homeodynamics, theorganismintegratesamassive numberofinformationsignals and includes thecapacitytocontinuouslyrecalibrate tohigherlevels offunctioning.In integrated experience” (p. 707).It paththat appearshumansare onanevolutionary previous dynamicbalance appropriate dynamicstate,butestablishesanew tothisnewly life functions.Oncestressor anew isencountered, theorganismnever returns toits homeodynamics “emphasizes the ever-adjusting nature oftheprocesses thatmaintain was firstappliedtoenergymedicineby Rubik (2002).In contrasttohomeostasis, countless informationflows (Rubik, 2002). nonlinear dynamicsofself-organizationthrough strangeattractors,nonlocality, and or ultimatebalancepoint,homeodynamicsisbasedonmodernbiophysicsandrecognizes and chaostheory. Whereas homeostasisisbasedonclassicalphysicsandadvocates asingle sciencesofcomplexityincludingopensystemstheory,contemporary self-organization, modes offunctioning(Rubik, 2002). The conceptofhomeodynamicscameout This refers toourcapacitycreatively respond tostressors by progressive developing new Homeodynamics DEBRA GREENE,PhD The ethericbody¬–andthephysical/ethericplanethatitoccupies—are reminiscent The ethericbodymayactasaregulator complexfunctionsinvolved oftheimportant, The term was coined by Yates (1994), a physiologist and biomedical engineer, and The multidimensional model recognizes the homeodynamic nature of human beings. The Etheric Body be limpandlifeless. Allmovement is possiblebecauseofthis energy body, a complex Leadbeater, 1927/1997;Powell, 1925/1997). Without it, thephysicalbodywould The Power Supply effect, andtheinternalsenses. Let’s lookatthese oneatatime. etheric body:thepower supply, effect,thereplica theinterface effect,the blueprint Chart depictingthehumanenergysystemcirca19thCentury Tibet (attributedtotheprophetRatnasara). The ethericbodyisthepower supply forthephysicalbody(Lansdowne, 1986; Five principles that I believe have relevance to body psychotherapy govern the EXPANDING THEDIALOGUE 61 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 62 International Body Psychotherapy Journal The Art and Science of Somatic Praxis (Gerber, 1988/1996). energy from the charkas is translated into hormonal, physiologic and cellular changes a majorendocrinegland” (Gerber, 1988/1996,p.128). Ultimately, thestepped-down 1972). “Anatomically, plexusand eachmajorchakraisassociatedwithanerve 1988/1996; Lansdowne, 1986;Leadbeater, 1927/1997;Powell, 1925/1997; Tansley, system(Gerber,meridian/nadi system,whichcorresponds tothephysicalnervous and nadis. withthephysicalbodythrough thecharka/The ethericbodyinterfaces energy istransducedanddistributedthrough adivergence ofpower lines—themeridians 1988/1996, 2000; Tansley, 1972). send energy/informationtothenadis,whichactastinyenergycapillaries(Gerber, 1988/1996, 2000;Hunt, 1995;Swanson, 2010; Tiller, 2007). The meridians,inturn, micro-photography, volt-ohm metersandmagnetic resonance imaging(MRI)(Gerber, including electromagnetic measurements, integratedpolarizationchargemeasurements, healing systemisused.Meridians have beenvalidated by anumberofscientificmethods, There are 14majormeridiansandseveral hundred minormeridians,dependingonwhich 2007). The chakras,inturn,feedintoenergy/informationchannels,calledmeridians. well aselectromyography (Gerber, 1988/1996;2000;Hunt, 1995;Swanson, 2010; Tiller, have beenscientificallyverified withelectrostatic measurements, soundfrequencies, as 2010; Tansley, 1972). plexusofthephysicalbodyandThese alignwiththemajornerve like energycentersandnamedthemaccordingly. 1927/1997; Swanson, 2010).It islikelytheancientshadcapacitytoseethesewheel- in diametertoseveral inches,dependingontheirstageofdevelopment (Leadbeater, as looking like spinning that wheels range or in vortices size from about two inches means round orwheel. Those whoare abletoseetheseenergieshave describedthem Leadbeater, 1927/1997; Swanson. 2010; Tansley, 1972). step themdown intoamore usableform(Gerber, 1998/1996,2000;Lansdowne, 1986; and nadis(Gerber, 1988/1996,2000). a vast energydistributionsystem that hasthree maincomponents:chakras,meridians, inches beyond it (Leadbeater, 1927/1997; Swanson, 2010). The etheric body consists of energy/information matrixthatinterpenetratesthephysicalbodyandextendsseveral DEBRA GREENE,PhD Metaphorically speaking, thechakrasare likepower stations where highvoltage There are seven majorchakras(Lansdowne, 1986;Powell, 1925/1997;Swanson, The chakrasare energytransformersthattakeultra-high frequency energiesand Chakra is a Sanskrit word that

Chart depicitngthesevenmajorchakrasandnerveplexustowhichtheycorrespond. HeartCenter Center SolarPlexus SacralCenter BrowCenter Throat Center CrownCenter EXPANDING THEDIALOGUE

Base Center 63 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 64 International Body Psychotherapy Journal The Art and Science of Somatic Praxis etheric body. 1976), verifying whattheancients have saidfor millennia: alllivingthings have an cells from plantsandanimals(Backster, 1968,1973,2002; Tompkins, 1972; Vogel, distance andover time.Interestingly, theexperimentalsoworks effectively using energy/information intheform ofemotionalstimulifrom theirprevious hostacross host? effect oftheethericbodyhelpsexplainhowThe interface cellscanreceive cells farremoved from thebodyregister thereal-time emotionsoftheirprevious cells from avast array ofpeople(Swanson, 2010). thousands ofmiles.It hasbeenrepeated hundreds oftimesby various researchers using This experimenthasbeenshown towork withdistancesspanning from feet to afew generating aspikeinvoltage (Backster, 2002;Backster & White 1985;O’Leary, 1989). strong emotion(pleasurableorpainful)the donated cellsbackinthelabrespond by voltmeter isonlyamonitoringdevice;nocurrent ispassedthrough thecells. measures andamplifies the weak electrical signal normally produced by the cells. The rinsing themouthinasaltsolution. Then thecellsare hookedup toavoltmeter that collected from apersonby swabbingtheinsideofmouthwithasterileswab, orby Backster & White, 1985; O’Leary, 1989).In thisprocedure, loosecellsare afew register emotionseven whenthecellsare removed from thebody(Backster, 2002; communication ofenergy/informationamongthebodies. Tansley, 1972). In essence, the etheric body is the “go-between” allowing for two-way 1988/1996, 2000;Lansdowne, 1986;Leadbeater, 1927/1997;Swanson, 2010; heavily influencetheethericbody, which,inturn,impactsthephysicalbody(Gerber, ways asthehigherfrequency energiesoftheemotional,mental,andspiritualbodies through the etheric body; the etheric body acts as a portal. worksThis gateway both and spiritual--creating reciprocity amongthem.Anyofthebodiescanbeaccessed between” thephysicalandthree remaining energybodies—theemotional,mental etheric body“backing”, itwouldbelimpandinanimate,unabletostandupormove. body together. ifthephysicalbodywere Likeacollarwithoutaninterface, withoutits reinforces the physicalbody, providing the energetic substancethatholds the physical theethericbodybody (viathechakra/meridian/nadisystem).Asaninterface, substance toit. The ethericbodyisprimarily“woven” onto theinsideofphysical isconcealedbetween layersthe garmentiscompletedinterface offabric. into.sewn It isusuallystitchedontotheinsideofanout-facingpiecefabric. When stand up. is to reinforceThe purpose of an interface or add substance to whatever it is most commonlyusedinthecollarofamen’s dress tomakethecollarstiffsoitcan shirt Tansley, functions.It important 1972).In performs theclothingworld,aninterface is mental, andspiritual(Gerber, 1988/1996;Lansdowne, 1986;Leadbeater, 1927/1997; between thephysicalbodyandotherenergybodies—emotional,as aninterface effect.ItOne explanationforthisistheinterface isbelieved thattheethericbodyacts mental health(Eden, 1998;Gerber, 1988/1996,2000;Krebs, 1998;Oschman, 2000). The Interface Effect DEBRA GREENE,PhD Again, conventional sciencehasnoexplanationforthis:whywould physical Then the cell donor is taken away, usually far away. When the donor experiences a by research effectissupported The interface thatdemonstrateshow individualcells goesbetween layersAn interface offabric.Similarly, theethericbody“goes So itiswiththeethericbody. It reinforces thephysical layer, addingformand The chakrasandmeridianshave beenempiricallylinkedtophysical,emotional,and 1986; Powell, 1925/1997). The body isareplica—the ethericbodyisthe“original” (Gerber, 1988/1996,2000;Lansdowne, The Replica Effect explain whyenergytherapiesare abletodothesame. able toproduce physicaleffects oftenwithoutever touchingthephysicalbody. It alsohelps 1972). The blueprinteffectoftheethericbodyhelpsexplainwhypsychotherapies are disease, pre-exist in the etheric body (Gerber, 1988/1996, 2000; Lansdowne, 1986; Tansley, physical body. As well, itmaybethatallaspectsofthephysicalbody, includingillnessand thatdetermine whatgoesintothestructure ofthethe energy/informationinstructions 2005). In effect,thisisthedomainofethericbody. lightoftheinterface such asemotions,thoughts,perceptions, andstatesofconsciousness(Church, 2007,Lipton, Epigenetics reveals themechanisms that influencegene activation canbenonphysicalfactors command isnotgiven atthephysicallevel. It comesfrom thelevel ofenergy/information. ofthebuilding,orrebuilding, genebecomespart process.particular In theseinstancesthe included inthephysicalstructure. Something outsideofthegenecandeterminewhethera are likethelumber, nails,sheetrock, andfixture choicesthatmayornotendupbeing are linedup, waitingtobegiven theorder tobeimplemented. Metaphorically speaking,they a geneisactivated (Church, 2007,Lipton,2005). the gene) has revealed an influence beyond the physicallevel thatdetermineswhether or not determining ourphysicality, fieldofepigenetics(epigeneticmeansabove thenew orbeyond over Althoughgenesplayafundamentalrole in thelastcoupleofdecadessuggestsotherwise. blueprint forthephysicalbody. However, groundbreaking research inmolecularbiology Powell, 1925/1997; Tansley, 1972). The conventional wisdom isthatgenesprovide the that ofablueprint(Gerber, 1988/1996,2000; Lansdowne, 1986;Leadbeater1927/1997; The Blueprint Effect psychological, andspiritualissues. and Touch forHealth, helpwithphysicalailmentsaswell tonamea few) asemotional, body (suchasacupuncture, homeopathy, Healing Touch, Emotional Freedom Technique, effectalsoexplainswhyenergymodalitiesthatdirectlyThe interface accesstheetheric allowing accesstotheotherbodies(physical,emotional,mental,spiritual)inprocess. pointintothetherapeuticprocess. Assuch,theethericbodyactsasagatewayentry multiple levels simultaneously. In somaticmodalitiesthephysical/ethericbodyis is takenintoaccount, thismysteriousphenomenon canbeunderstood. In theinstanceof To this day, modern medicine is hard-pressed to explain it. However, when the etheric body phenomenon, documented in medical books since the 1700s, is referred to as from pain andelectricalshockstoitchingsensationsofheat cold. -everything This conventional Western science hasnoviableexplanation for: phantom painandcellularmemory. of etherictissuesandlimbs. This helpsexplaintwowell-documented phenomenathat Incells have ethericcounterparts. otherwords, ourethericbodiesare comprisedofamatrix The ethericbodyissometimesreferred toastheetherictwinordoubleinthatphysical It blueprintforthephysicalbodyisethericbody. appearsthatthe true It maycontain According toepigenetics,ourgenesare more likebuilding materialsthanblueprints. They function— anotherimportant In theethericbodyserves additiontobeinganinterface, effectalsohelpsexplainwhybodypsychotherapiesThe interface are soeffective on About eightypercent intheirmissinglimbs- ofamputeesreport somekindofdiscomfort replica effectmeans that all glands, bones, muscles, organs and EXPANDING THEDIALOGUE phantom pain. 65 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 66 International Body Psychotherapy Journal The Art and Science of Somatic Praxis routinely encountered andworked withinbodypsychotherapy. whichis information matrix—helps elegantly explainthephenomena of cellular memory transplant recipient. Indeed, thepresence oftheethericbody—withitsinvisibleenergy/ intact, woven andwouldcontinuetransmittingitsmessagestothe intothephysicalheart, this maywork. ofthevictimwouldremain Despite havingbeentransplanted,theethericheart the etheric body and the replica effect are brought into the picture we can understand how reported aboutthecrimeturnedouttobeaccurate even thoughshehadnopriorknowledge ofit. the police. Using her descriptions alone they were able to locate and convict the killer. What she the murder andthekillerinsuchminutedetailthatpsychiatrist wascompelledtocontact brought thegirltoapsychiatrist forhelp. The girlwasabletodescribethevictim,sceneof a manmurdering ayoung girl. The dreams were sovividandpersistentthatthemother finally the girlorherfamily, yet soonafterhertransplantshebeganhavingdisturbingnightmares about of aten-year oldwhohadbeenmurdered. The donorinformationwascompletelyunknown to Pearsall, Ph.D., in hisbookTheHeart’s Code (1999). An eight-year oldgirlreceived theheart through recognition oftheethericbody. and informationfrom thedonor’s lifethat appear tohave nootherexplanation except, perhaps, clothing, music,cars,andsexualbehaviors)(Pearsall, 1999). They alsoexperiencememories qualities andhabits(drinking,smoking,swearing, praying)andpreferences (intermsoffood, changes inpersonality(shiftingfrom extroverted tointroverted), ortotakeonthedonor’s studies, organdonorrecipients have beenshown toexperiencestrange andsometimes drastic and behaviortraitsoftheirorgandonorswithoutever havingmetthem.In documentedcase evident ininstanceswhenorgantransplantrecipients mysteriously takeonthepersonality on transmittingmessagestotherest ofthesystem. etheric armwouldcontinuefunctioningand,asanenergy/informationmatrix,itcarry still beintactandconnectedwiththerest oftheetheric body. If anamputeelostarmthe amputation, even thoughaphysicalappendagehadbeenremoved, theethericlimbwould DEBRA GREENE,PhD where attention goes energy flows. Attention inandofitselfhas potency (Radin,2002,where attention goesenergy brings tolifethat whichitisdirected on.Awell-known axiominenergymedicine is: external andinternal sensesonit.Attention islikeaspotlight thatilluminatesand Attention the contextofenergytherapies. constitute familiarterrainforbody psychotherapists, Iwilldescribethembrieflybelow within valuable innerresources thatimpactourhealthandwellbeing. Although theinternalsenses The ethericbodyishighlyresponsive toinputfrom theinternalsenses. Assuch,theyare (Greene,attention, self-sensing, self-talk, intention, visualization, and self-observation 2009). body, inparticular, canbeaccessedandworked withthrough theinternalsenses. These include internal, subjective worldofsubtleenergies. The energybodies,ingeneral,and theetheric senses thatorientustotheexternalworld,we have internalsensesthatorientustothe Materialist sciencehasnoexplanationforthephenomenaofcellularmemory. But when Probably is a case documented by Paul the most profound example of cellular memory The phenomenonofcellularmemory, familiartomanybodypsychotherapists, isquite Attention isfocused awareness. When we payattentiontosomething,we focus our A finalprinciplethatmeritsinclusioninvolves theinternalsenses. Just as we have external The Internal Senses these modesofinnercommunication thatformaperceptual layer over our“raw” experience. of thethree typicallymore predominant (Dunn, Griggs, Gorman, etal.,1995).Self-talk includes channels aspossible.Still, andkinesthetic,with one processes are thethree visual,auditory primary orientations includemathematical,spatialandmusical.Ideally, we wouldwanttoemploy asmany sensations and feelings, a felt-sense about things (Dunn, Griggs, Gorman et al., 1995). Additional conjure up clear, vividmental images or movies. Others, more kinesthetic, will experience bodily envision, thewords andstorieswe tellourselves constituteself-talk. meaning we give towhatwe perceive, how we it,whatwe view feelaboutit,thepictures we inputinitspureperceives form;itisalwayssubjecttopersonalinterpretation. sensory The Self-Talk experience subtleenergyflows andtoaccess andexpress theenergybodies. of somaticmodalitiesandbodypsychotherapies. In energymedicine,self-sensingisusedto effects (Feldenkrais, 1990,1997),as is evidentintheconsistentoutcomesfrom aspectrum body psychotherapy. Bringing attentioninsidethebodyviaself-sensinghasproven therapeutic subtle internal cues (Hanna, 1988;Feldenkrais, 1990, 1997).Self-sensing is foundational to sense how thebodymoves ingeneral.It canalsobeusedtosensepainorapprehend more receptivity thatopensusuptoavariety ofproprioceptive inputs. experience(Greene,with primary 1995,1997,1997-98).Self-sensing isachannelofinternal Itinsights, imaginings,andsoforth. isamodeofinternallisteningthatputsusintouch a vast arrayofinternalfunctioningincludingbodilysensations,feelings,thoughts,intentions, at timesbroadening that focus toinclude the entire body. Self-sensing allows for experiencing shifting attentionawayfrom anexternalfocusanddirecting attentiontoward aninternalfocus, inner-focused, subjective stanceofexperiencingfrom the“insideout”. Self-sensing occursby Self-Sensing body psychotherapies alike. (i.e., awareness) isatransformative energytool thatisfoundationaltoenergytherapiesand ofbringingawareness tosomething,inevitably changesit.Humanobservation, attention commonly taughtinterpretations ofquantummechanics.It holdsthatthemere actof (Heisenberg, chooseswhattoobserve 1979). until anobserver This isoneofthemost objectissaidtoexistonlyaspotentialCopenhagen interpretation inwhichanunobserved & Zurek,around 1926 (Wheeler 1984). by the supported The notion was further Werner Heisenberg principle whenhepublishedthemathematicsofuncertainty somethingaltersitinsomeway. actofobserving the very information andischangedatafundamentallevel. Sometimes effect, calledtheobserver 2002a; Radin & Nelson, 2003). What we focus our awareness on receives our energy/ of consciousness are understoodtoimpact physicalmatter(Swanson, 2010; Tiller, 1997,2005, Swanson, 2010),intentions, (Radin&Nelson, 2003),words (Emoto, 2004),andother aspects isenergy,in whicheverything thoughts(Hawkins, 1995;Lipton,2005;Sheldrake, 2003; playing insideourheads,thenoisy mind,ortheinnercritic.In theparadigmofenergymedicine, Some researchers refer to self-talk as Some channel and think in words. ofus orient through Somean auditory who are more visual Self-talk constitutesthemessageswe tellourselves aboutwhatwe experience.None ofus Self-sensing canbefocusedonaselectedorganorarea ofthebody, ormore expandedto Self-sensing isthecapacitytoturninward andfocusattentiononbodilyexperience. It isan This surprisingaspectofreality wasfirsttouchedon by Nobel Prize-winning physicist explanatory style, but most of us know it as the “tapes”explanatory EXPANDING THEDIALOGUE 67 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 68 International Body Psychotherapy Journal The Art and Science of Somatic Praxis experiment and otherslikeithave beenrepeated withconsistentresults. (23% improvement). The control group showed no change (Martin, Moritz & Hall, 1999). This practiced free throws at the gym (24% improvement) versus those who stayed home and visualized After a month there was only one percent difference in the achievement level of thosewhoactually successful free throws for20minutes eachday. The third group, thecontrol group, didnothing. basketball free throws. Asecondgroup wasaskedtostayhomeand simplyvisualize completing groups. One dayfor20minutesandpracticemaking group wasaskedtogoanearby gym every by athletestoimprove In were performance. onesimplestudyparticipants dividedintothree the brainandonourhealth(Doige, 2007;Hansen &Mendius, 2009).It isoftenusedsuccessfully purpose inenergytherapies.Likeself-talk,visualizationhasprofound effectsonthestructure of I usethetermvisualizationotherorientationsare includedaswell, notjustthevisual. andkinesthetic.Probablyauditory abettertermwouldbesensualization (Greene, 2009). When suggests, visualizationisnotlimitedtothevisualrealm. It includesotherchannelssuchas way. We allhave thisabilitybutsomehave developed itmore thanothers.Unlike thename Visualization Dibble, 2000),andchocolate(!)(Radin,Hayssen & Walsh, 2007). (Nelson & Radin,2001),electronic devices (Tiller, Dibble & Kohane, 1999; Tiller, Kohane & Hayssen, Emoto &Kizu,2006),cancercells(Radin,Stone &Levine,etal.2008),computers bacteria, DNA(Radin&Nelson, 2003),yeasts (Radin, Taft & Yount 2004),water(Radin, from felloweverything humans(Radin,Machado &Zangari, 2000),toanimals,insects,plants, intent, there were noeffects--acleardemonstrationoftheprecise power ofintent. the monitoringdevices(Radin,Machao &Zangari, 2000).Duringwhenthere wasno intervals sending theirhealingintent,thevolunteers’ bodieswere registering theeffectsasrecorded by blood volume, breathing, and skin activity. that the healers were At the exact timed intervals five volunteers were hooked up to various monitoring devices tomeasure rates, their heart five volunteers who were over 6000milesawayina research labinLas Vegas, Nevada. The energies toanyplaceattime(McTaggart, 2007;Radin,2006). & Braud, 1997; Targ, 1997).Intent canbeusedtomobilize ourown energiesandtodirect research onthehealingeffectsofprayer demonstrates(Braud, 2000;Dossey, 1993;Schlitz human intent.Our energybodiesare extremely responsive tointent(Saraydarian, 1981)as follows intent,reflects thepower assigned to foundational axiominenergymedicine, focusing attentiononsomeoneorsomething;we willfullydesire outcome. A aparticular Intention a higherhomeodynamicfrequency. and words thatconstituteinnerchannelofexpression—the entire systemcanrecalibrate to atthelevelbringing awareness ofself-talk--changingthepictures, toandintervening sensations In whathasbecometheanthemofneuroplasticity: neurons thatfire togetherwire together . By actually changesthephysicalstructure ofourbrains(Doige, 2007;Hansen &Mendius, 2009). 2007). by researchThis issupported inneuroplasticity thatshows thatourmentalexperience DEBRA GREENE,PhD Visualization isimaginationcoupledwith intent.It isnotdaydreaming, brainstorming, or Visualization, orguidedimagery, isapotenttoolformobilizingenergiesandusedthis As aninternalsense,visualizationrefers toourcapacityformconceptsinanintentional Experiments suchasthisandhundreds ofothersconfirmtheeffectshumanintenton In Sao Paulo, Brazil, onJune 3,1998,three healerswere directing healingintentionto Intention isattentioninfusedwithwill(anotherinternalsense),inwhichwe are notjust Like ourexternalsenses,theinternalsensescanberefined andhoned. are naturalqualitiesthatwe intrinsicallypossess, similartoseeing,hearing,tasting,andsoforth. clients torealize these are notforeign to attain. or difficult skillstheymust struggle Instead, they psychotherapists. Ihave sensestoclientshelpsempower foundthatintroducing themasinternal different labelsmaybeused,manyoftheinternalsensesconstitutefamiliarterrainforbody Presenting issuesare understoodasimbalanceswithinandamongtheenergybodies.Although are meansbyself-observation whichtheenergybodiescanbeaccessedandworked with. andtoachieve higherstatesofconsciousness. interventions, isusedtotracksubtleenergies,assessenergymedicine energy medicine,self-observation 2012). Self-observation isafoundationalcomponentofbody-orientedpsychotherapies. In (Farb, Segal, Mayberg et al, 2007; Williams & Kabat-Zinn, 2011; Segal, Williams, & Teasdale, what isgoingoninside,spectating,asitwere, (Greene, insteadofactively participating 2009). itinamore we are detachedway.with self-observation observing We are witnessingorwatching functioning thatwe are focusedon;we are actively engagedwiththeinnerlandscape.In contrast, difference. With self-sensing,we are experiencingthemultitude, orspecificallyselected,internal bodily sensations)andmaysoundsimilartoself-sensing.However, there isafundamental of us.It includesaccess tothearrayofinternalfunctioningmentionedabove (thoughts,feelings, Self-Observation the abilitytoholdafocus,whichallows formore robust results. research conductedonintentionisdoneusingtrainedmeditators,asmeditatorshave developed The more focusedtheconcentration,stronger theresults. This iswhythevast majorityof Visualization ispurposefulimagining,holdingaspecificfocus through thepower ofconcentration. stream-of-consciousness thinking,nordoesitinvolve expandingthemindtoseewhatfloatsin. dynamically recalibrate toahigher level of functioning. In keeping withtheprincipleofhomeodynamics addressed above, theentire system would inturn,wouldradiateout toeffectchangesintheother bodiesaswell. types ofinterventions, enter through themental bodyandeffectchangeintheemotionalspiritual bodies. These and mentalbodiesduetothe closeproximity of theirfrequency domains.Similarly, we can example, we canenterthesystemthrough thephysical/etheric bodyandimpacttheemotional appropriate effects. toenergy work, we couldthinkintermsoffield effectsorradiatory For effect changeatthatlevel which,inturn,wouldprecipitate outtoaffectalltheotherbodies. and spiritual).In atop-down approach, we canenterthe system through thespiritualbodyand how bodypsychotherapies work toeffectchangeonalllevels (physical/etheric.emotional,mental, effectoftheethericbodyoffer anelegantdescriptionof multidimensional modelandtheinterface the physical/ethericbodyandgainaccesstoallotherbodies. AsIhave suggestedabove, the are seenasdistinctyet overlapping. In abottom-upapproach, we canenterthesystemthrough intothebody-mind-spiritsystem.It points ofentry isaholisticmodelinwhichtheenergybodies bottom upapproach? The answer is:itdepends. The modelissuchthatitrecognizes multiple The internal senses of attention, self-sensing, self-talk, intention, visualization, and Sometimes thispracticeiscalledmindfulnessandithasdocumentedtherapeuticeffects Self-observation refers and become aware to the ability to of observe what is going on inside Using aframework otherthantop-down/bottom-up, onethatis lesshierarchical andmore The questionthenarises:wouldthemultidimensionalmodel beconsidered atop-down or Top Down Up? orBottom EXPANDING THEDIALOGUE 69 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 70 International Body Psychotherapy Journal The Art and Science of Somatic Praxis DEBRA GREENE,PhD Backster, C.& White. (1985). 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73 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 74 International Body Psychotherapy Journal The Art and Science of Somatic Praxis brother orsisterwhen twin-type THT isused.In thecaseinvolving aprofessional co- participate). The co-therapist canalsoassumetherole of thepatient’s imaginedtwin symbolic mother/father/sibling role (iftherelative isnotavailable or doesn’t wantto her armorhavinghim/her sit onhis/herlap. The professional co-therapistassumesa co-therapist, theco-therapistmakesbodycontactwith client,e.g.by touchinghis/ therapist, etc.). While thehypnotherapistkeepsadistancefrom both theclientand hypnotherapist)oranotherprofessional person(anurse,anoccupationala supervisor or mayeven bethepatient’s individualtherapist(inwhichcasethe hypnosisisdoneby and the therapist. The co-therapist can be the client’s natural mother, father or sibling, THT. In caseofathree-person are settingtheparticipants theclient, co-therapist elicit apositive, corrective experiencewiththepotentialofresolving theclient’s trauma. clients are usuallyinadeeperstateoftrancethantheco-therapist. The aimof THT isto oradeepertrancetogetherwith theclientintandemsituation. a superficial The hypnotherapist. During THT, there isapossibilityfortheco-therapisttogoeitherinto involves ofmore theparticipation thantwopersons:theclient,co-therapistand traumas. It wasdeveloped years by theauthorsafew ago(Vas &Császár, 2011a). THT method forresolving psychopathology ofinter-generationallymediatedpre- andperinatal ( P. JÓZSEFVAS, MD,ECPANDNOÉMICSÁSZÁR,PhD, 1 © Author andUSABP/EABP. Reprints andpermissions [email protected] Volume 12,Number 1,2013pp74-86Printing ISSNNumber 2169-4745Online ISSN2168-1279 International BodyPsychotherapy Journal TheArt andScienceofSomaticPraxis former editorofthe International Journal ofPsychotherapy, ideasinour study. clarifyingcertain fortheirefforts and Symbol therapy, Prof. Ferenc Túry, former president oftheHungarian Association ofHypnosis, and Tom Ormay, Hungarian Association ofHypnosis Hungary, Prof. Emőke Bagdy Prof. Ontapadó Jegy, Hungarian Society of Relaxation T TANDEM). Tandem formofgroup asanew hypnotherapy—a hypnotherapy(THT) We wouldliketothankProf. Éva I.Bányai,former president of theInternational Society of Hypnosis, andthe ouch ofA transference. Three casevignettesare presented toillustrate how THT works. acceptance andlove. The essenceof THT isviewedasanintegrationoftouch, trance,and traumas can be replaced with an associative mode of prenatal experiencing which includes mutual attunementevolves during THT. By using THT thesymptomsofpre/perinatal co-therapist gointohypnosistogether. Meanwhile, thetherapistkeepsadistance.A from pre/perinatal traumas. While multi-persontouchinghappens,thepatientand hypnotherapeutic methodforresolving psychic andpsychosomatic pathologyoriginating Tandem hasrecently been developed by the authors. hypnotherapy It(THT) is agroup According we candistinguishbetween tothenumberofparticipants, twosettingsof By “tandem” we meanseveral things:1.amulti-seatedbicycle; 2.anacronym for Submitted 3November 2013;received inrevised form21February 2013;acceptedMarch 2013 P. JózsefVas, MD,ECPandNoémiCsászár, PhD,ECP Key words: touch,trance,transference, mutualattunement ncient andN ew Generations withaD ew Tandem Hypnotherapy Abstract ialogue E xperiencing Oneness ofM 1

inds 1965/2001). lovepsychoanalytic asameansofexpressing primary techniquewasusedtoserve (Balint, love towards the patient.One maybereminded ofthework ofMichael Balint whose touch thepatient,co-therapistmustthenmediatetherapist’s acceptanceand andhelpsthepatientcopewithhis/hertrauma.Astherapistdoesnothe supports co-therapist’s mediatingrole seemstobeasignificantcomponentof THT becauses/ psychological healingteamthatfunctionscooperatively forthepatient’s benefit. The one clientandco-therapist(Vas &Császár, 2011b). to conductthe THT withasettingofmore than three persons,there maybemore than patient andtheco-therapistofoppositesex,i.e.touchinghands.If we want in awaythatallows onlytheslightestamountoftouchtoberealized between the carefully setbecauseofethicalreasons.of thetherapymustbevery It shouldbearranged or amalepatienthassuffered seriousphysicalorsexual abuseasachildtheframework therapist, he/shemaybeofthesameoroppositesexaspatient. When afemale family members, inorder toreveal lostobjects or vanished memories, ortoimprove when trancewas employed with more thanonepersons, forinstancewithcouplesand ofhypnosis, whichwereseveral sessionsthroughout calledtandem hypnosis, the history 1993). However, touch in tandem hypnotherapy has a different role. There have been communicate withthepatient’s unconscious mindwithoutwords (Cheek,1980,1986, same. Touch isgenerallyusedasthehypnotherapist’s ideomotorsignaling techniqueto to the background. The situation with touch in regard to hypnotherapy seems to be the regarding20th century spatialsetting,whileproximity psychotherapies were relegated in treating somaticillnesses(Krieger, 1975). 1994; Young, 2007).Non-contact touchisalsoemployed asanenergyhealingmethod and dancetherapies,bio-energeticmethods,haptonomy, etc(Meyer, 2010; Veldman, 2008). At present, several proximate typesexistsuchasbodypsychotherapy, movement- psychotherapies, dubbed“re-birthing therapies”, torelive process (Grof, thebirthing massage (Reich, 1976).Later, Frank Lake,Leonard Orr andStanislav Grof practiced and made the patient siton his lap. Wilheim Reich’s orgone therapy was based on bodily a Hungarian analystSándorFerenczi (1933, 1988)appliedtheproximate methodagain after Freud refused proximate hypnosisforthesakeofdistancinganalysis, hisfollower, attitude stillappliestotoday’s manypracticesandtheoriesofpsychotherapy. However, regarding hismagneticcures—and Freud, ofabstinence. whointroduced therule This about whomtheFrench Academy expressed anethicaljudgmentinasecret report historically reluctant attituderegarding touchingthatcanbetracedbacktoMesmer— therapy have changedwiththeemergenceofmodernpsychotherapy. There hasbeena physical closenessbetween membersofatribe(Krippner, 1993),proximate typesof and therapist(Hermann, 1934/1984). While even ancientshamanisticpracticeinvolved types of distal or distancing therapies characterized by spatial distance between the patient settings: first,proximate typeswhichare characterized by physicalcloseness;andsecondly,

Distal therapiesdominatedthepsychotherapeutic mindsetthroughout thewhole According toethno-psychology, there are two types oftherapies regarding spatial The triadcontainingthepatient,therapistandco-therapistformsa Brief of History Touch inPsychotherapy TANDEM HYPNOTHERAPY 75 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 76 International Body Psychotherapy Journal The Art and Science of Somatic Praxis P. JÓZSEFVAS, MD,ECPANDNOÉMICSÁSZÁR,PhD, approaches thatare tobeintroduced intherapy. be described). This integrationisviewedasaguidingprinciplealongwiththedifferent trance andthemultipletransferences thatevolve (whichwilllater amongparticipants psychology 1997),andtranspersonalpsychology (Janus, (Wilber, 1986). developmental neuropsychology (Schore, 2003),prenatal andperinatalmedicine & psychology (Cosmides, Tooby, 2001),ethno-psychology (Hermann, 1934/1984), (Böszörményi-Nagy &Krasner, 1986),rebuilding therapy(Gass, 1997),evolutionary 1998), psychodrama andhypnodrama(Moreno, 1987),contextualfamilytherapy 1988), Jungianpractice (Jilek, archetypal therapy (Jung, 1978), hypnotherapy (Bányai, asitstheoreticalsources andmethodologicalroots: whichserve ancientshamanistic despite itssimilaritieswiththemethodsmentionedearlieraswell asthefollowing original therapeuticapproach bothinthetheoretical andthemethodologicalsenses, Wildmann &Szentes, 2011). Because ofitsemphasisontouch, THT isviewedasan has successfullybeenusedwithidenticalfemalebulimictwinswithouttouch(Túry, played anessentialrole inthistypeoftandemhypnosis.Recently, tandemhypnosis relations amongrelatives (Kluft,1987).However, touchandphysicalclosenessnever desired, the necessary modificationisdoneforthesakeofpatient’sdesired, thenecessary comfort. ask ourpatientstotellushow theyfeelabout beingtouchedby theco-therapist, andif unpleasant, confining,aggressive, possessingorerotic. Before inductionof THT, we always stringent. This iswhytheemphasisontouchinpsychotherapy isforitnottobeexciting, their children, whichmayeasilyexplainwhytherelating ofpsychotherapy rules are so Western cultures seemtoexhibitanaversion totoucheven inparents’ attitudetowards legal considerationsfortouchwithinpsychotherapy. They draw attention tothefactthat his orherbiologicalneeds;andifs/hefeelstouchingtobe anaturalthing(Bálint,2005). therapyasaresource doesnotview of forprofessional supervision; has theopportunity knowledge andself-experiencebefore usingtouch;isabletohandletransference securely; urges). The therapist’s touchiseffective intherapyifs/hepossessesastrong foundationof adequate diagnosis(noparanoidhostility, homophobia,orunbearableaggressive orsexual touched; s/hegives permission to thetherapist; s/he is abletosay no; and s/he has an that touch is therapeutically effective only if the patient wants to touch or wants to be the conclusion,regarding theconditionsthatpatient’s setforeffective touchintherapy, and boundariesare foundtobefundamental.Clinicalstudiesoftouchhave cometo closeness andintimacy. However, theethicsoftouchintherapyare essentially different (Phelan, 2009). Touch isviewedasanormalactamongpeopleforexpressing friendship, In the1980s,Patrick Casement’s casedrew attention totouchasanon-erotic challenge smoking, alcohol and drug addiction, themother’ssmoking, alcohol anddrug severe somaticillnessand/orsurgical the formof either of the following: intrauterine infection (i.e. flu),intoxications like Pre/Perinatal Traumas andtheDevelopmental Levels ofApproach inPsychotherapy

All psychotherapists know how careful theymustbe regarding touching their patients. Prenatal traumaoccurs whenanexpectantmother andherfetushave distress in The authors suggest that the essence of THT is the integration of touchwith Zur and Nordmarken (2011) have recently compiled a list of clinical, ethical and Ethics of Touch inPsychotherapy when shewas pregnant withher. deficit and lack of impulse control. Esther’s to drink alcohol regularly mother started now withthe consequences:dyslexia,borderline struggles personality disorder, attention the youngest ofwhom,17-year-old Esther, experiencedfetalalcoholicbraindamageand divorced his previous wife because of her massive alcoholism. They had three children, Treating aBorderline Patient with THT (therapist: Dr. Vas, co-therapist:Dr. Császár) publication. The clientnamesmentionedinthispaper are fictionalandnon-identifiable. below madereports basedontheirown experiencesandgave theirwrittenconsentfor for interpretation ofitsapplicationsinclinicalpractice. describedThe participants clinical experience,we describefirsthow themethodworks, andthentherelevant theory which thetraumaoccurred. This approach willbeillustratedby thefollowing cases. be treated by atherapeuticapproach thatfunctionsonthesamesensorimotorlevel on information processing attheprenatal periodoflife. This iswhythesedisorders needto and somaticdisorders canoriginatefrom adeficitinthesensorimotorandvisceral asearlyfetallife. development starts We suggestthatseveral psychic, psychosomatic (1937/1954) as the sensorimotor period. We believe that the sensorimotor period of to have stress-relieving, calmingandlove-inducing effects(Varga, 2009). role ofoxytocin excreted whenpeoplegetcloseinorder totouchoneanother. Touch issaid protection, security, warmthandlove. emphasizes the ofsocialsupport The neurochemistry viamirror neuronspartners (Bauer, 2010); inotherwords, touchisessentialforexperiencing 1999). Thus, touchisresponsible forreliving spatialregression, whichisanattunementwith touch isprocessed intherighthemisphere, whichrepresents relations and contexts(Siegel, the egoandnon-egothatisbasisforattachmentrelationships. The experienceof toestablishthefrontiers ofthebody,absolutely necessary andtoevolve theboundariesof first languageofdeveloping babies(Montagu, 1986). In thefetalperiodoflife,touchis to developmental neuropsychology, touchappearstobethe“mother” ofperception andthe psychosomatic andpsychological dysregulation andintheworstcases,disorders. the original sensorimotor level forms of stress, against new which can leadtosomatic, & Turner-Groot, 1999; Verny, 1996). will be repeated atThis implicit somatic memory (Turnerhaving becomeincorporatedintothepersonalityasanimplicitsomaticmemory coping strategiesrepeat thepatternsofover- ordown-regulation previously secured, regulation ofthedeveloping personality, stress andwhenfacingnew situations, the such asaCaesarean section,intensive perinatalcare, etc.(Emerson, 1996). 2009). We occurs canspeakofperinataltraumawhensomeformcomplicateddelivery likeamniocentesis,etc.(Hugo, 1997),orprenatal (Janus, medicalinterventions abortion situations offamilymembers(Austermann &Austermann, 2008),attemptedartificial mother’s negative emotionalattitudetoward orneglectofthebaby, deathordire life (Robertson, 2010),themother’s insufficientmourningofprevious orcurrent loss,the orphysicalexhaustion(Bergh, 2002),Blighted starvation intervention, Twin Syndrome The authorshave beenworking withabroken familywhosefather, Sebastian, Since thedevelopment of THT wasbasedoninferences drawnfrom theauthors’ The patterns ofcoping with peri/prenatal traumasare built into the bio-psychological The earliestphaseinthechild’s cognitive development wasdescribedby Piaget How canthistypeofpathologycausedby prenatal traumabetreated? According Case Vignettes TANDEM HYPNOTHERAPY 77 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 78 International Body Psychotherapy Journal The Art and Science of Somatic Praxis P. JÓZSEFVAS, MD,ECPANDNOÉMICSÁSZÁR,PhD, watching astream. totransformherselfintotheThen, intandemtrance sheisinstructed was fragileasa fetusfrom theintrauterine infection.Angieenjoys beinginameadow and trance, hermother’s asaholdingenvironment becauseAngie’s role wastoserve security withnature symbolsofameadow,imagery astream, atree, and aflower. In tandem Since Angieseemedtohave egoweakness, Dr. Vas decidedtoinitiateguidedaffective family. She became33kilograms andallshewasabletodolieinbed. tosave moneyforthe tense.Angiefeltthatshehadtostarve atmosphere hasbeenvery Recently, hergrandmotherdiedandparents’ enterprisewent bankrupt. The family years a drasticslimming diet a few ago after breakingstarted up with her boyfriend. lost prenatally. Asachild,shewasoverweight andwasbulliedby herschoolmates.She and herphysicalappearance.She hasalwayssuspected she hadatwin-siblingwhowas graduate from highschool,soshewasinapremature stateregarding both heremotions prematurely. It isaninteresting parallelthatwhentherapybegan,shewasjustaboutto cm. Ashermotherhadanintrauterineinfectionduring pregnancy, Angiewasborn Treatment ofAnorexia Nervosa With Mother-Daughter THT (therapist:Dr. Vas) therapy isnotyet finished. she wasbefore. Since thenhertherapyhascontinued inanindividualframework. Esther’s a lovely red tulip. was toholdEsther, herfetus,intherapy, asMother mightholdherplants,namely Earth was notabletosayaword. It mayhave happenedbecausehercounter-transference role alcoholism. Afterhypnosis,theco-therapiststatedthatwhileshewasindeeptrance, to eliminatetheharmfulimpactsEsthersuffered asafetusresult ofhermother’s of transference, we caninterpret thetherapistasrepresenting agoodfatherwhowants viewed asharmfuland needingtobeswitchedformore adaptive techniques. protected herlifeinthefetalperiod. Within thetherapy, however, thesesymptomsare were treated asamechanismofbio-psychological selectionofharmfulstimulithatprobably in suchawaythatEsther’s symptoms(dyslexia,attentiondeficit,lackofimpulsecontrol) able toseparatepoisons,thetherapisttookcare topaintEsther’s fetalalcoholpoisoning Esther toimagineherselfchangingintoatulipwithbigbulbundertheground which is expressed thatherchesthadbecomelighter, free from aheavyburden. develop intoabeautifulred tulip, sheshedtearsagain.Upon returning to humanform,she In thatmoment,Estherburstintotears. When thetherapistsuggestedthatshe would not beabsorbed;poisons would be stored inthebulb instead ofcausingharmtotheflower. bulb isstrong andcanseparatenutrimentsfrom poisonsintheground sopoisonswould bulb undertheground. The therapisttellsherthatthetulipishealthyprobably becausethe transform herselfinto. While beingatulip, shecanfeelwell andexperienceshavingabig and askedhertoselectaflower. She lookedata red tulip, whichthetherapistaskedherto environment via touching and caressing. The therapist made Esther imagine a meadow trance withherbiologicalmother. Astheco-therapist, Dr. Császárgave Estheraholding mother-daughtercontextasEstherdidnotwanttoengageintandemtherapist inavirtual Angie andhermother—who wasalmostasthinAngie—agreed tocome THT. andweighsAngie, age18,hasadiagnosisofanorexia 33 kgataheightof170 nervosa After thistypeof THT waspracticedthree times,Estherbecamemore relaxed than This sessioncanbeviewedasaformoftransference aswell. Within thevocabulary In this THT session,Dr. Vas asthehypnotherapistandDr. served Császártheco- It thatthesuggestedmetaphorbeproperly articulated. isimportant When asking separation into herpersonalityintheframework ofindividual therapy. of bipolaraffective disorder. the four-month THT periodAngieweighed kilogramsandhadnosymptoms forty-five (in apsychological sense)toherdaughterandhelp develop herfemininity. At theendof repeat herpregnancy withAngieinfantasy, toprovide bettermotheringandexpectancy through additional development aswell via THT. Her main“transference” issuewasto unconscious symbiotic need. As a matter of fact, the mother’s personality had gone deficit, Angiehadtosymbolicallyassumetherole ofafetus—thiswashermother’s on satisfyingtheirsymbioticneeds.In accordance withthefetalsensorimotorlevel of corresponding periodofthetherapyinvolving hermotherintandem,we were focusing bursts intotears. and guard theothertwinduringherlifeonearth. While thissuggestionisgiven, Angie be born.Instead onewouldhave tokeepinmindthateither Wendy orAngiewouldlove the case,neitherofthemwouldfeelsorrow or guiltbecauseoftheotherhavingfailedto true. Therefore Wendy emphasizes thatoneofthemmayfailtobeborn.If ithadbeen hardmuch, shewouldliketobebornatthesametime,butthat itisvery tomakeitcome notices anicegirl, Wendy. Dr. Vas suggestedthat Wendy saythattheylove eachotherso have adream inwhichsheandhertwin-sibling meetintherealm ofunbornbabies.She feels joy andthetherapistsuggeststhatshesleepinwomb beingintheuterus exhibit femininefeatures intheeyes ofothers aswell. can betakenasametaphorofherunsatisfiedsymbioticfetalneeds.She to thenstarted a latersessionsheimaginedherselftransformingintotree withtropical flowers, which this suggestion,hersleepgraduallycametobeaconsistentsixeighthoursnight.In and calmeddown whiledeepening,inorder toaccumulatestrength. Asaconsequenceof and hermotherimaginethatasastream, Angiereaches alittlepoolinwhichsheisslowed course ofthetherapyandslow herdown. Following thetherapist’s Angie instructions, whether shemighthave bipolaraffective disorder. Dr. Vas thendecidedtochangethe a valley. This hyperactivityandtheprevious periodofinactivityraisedthequestion hours anight.It seemed asifshehadidentifiedherselfwithafaststream down running day that she slept only three inactiveto study so much every Angie suddenly started field”.goals inevery like goldandsilver. Iconsiderthisstream tobemyidealthatIamgoingreach my capable ofreaching itsgoal.It itlooks isbeautifulwhenthesunshinesonitssurface; had immensestrength. It iscapableofcopingwithcliffsandotherobstacles anditis transformed intoastream. This littlestream wascapableofpurifyingitselfbecauseit thoughts are citedfrom herdiary: fluid, whichexhibitsfeatures ofself-purificationandever-reviving energy. The following prenatal experienceofinfectionby experiencingherselfasafluid—aclearamniotic power. At the sensorimotorandviscerallevel she is able to overwrite the traumatic as asymbolicmessageofpurificationfrom prenatal infectionandofgainingancestral ever-reviving becausethespringwaterwouldalwaysfeedher. This canberegarded both stream. Asastream shefeelsismoving, continuallyflowing, shecanfeelherenergy Angie’s therapy is not yet finished as we plan to work on integrating feelings of Later inreal excellently life,Angieperformed onhergraduationexam.During the In thenextsessionAngieandhermothertoldusthatafteroneyear oflying in bed “During theprevious imaginationIhadanincredible experiencewhenIwas On alateroccasion,theyimaginedAngieasnot-yet-born fetus.Angiesaysshe TANDEM HYPNOTHERAPY 79 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 80 International Body Psychotherapy Journal The Art and Science of Somatic Praxis that you love her, too.” Again,Cynthia sobbing and theygive eachother aclose starts will lookintoeach other’s eyes, andyou willknow how muchyour mother loves you and sunlight; Cynthia, you have beenborn. You willbeputonyour mother’s chestandyou her head,bowed until now. At thispoint,Dr. Vas says,“Your headhasemergedintothe a positionlyingonherback. Cynthia islying onherstomachfacingmotherandlifts slowly tomove starts by making two rounds and a half with herbodywhile Regina takes again, repeating how Cynthia knows moving when to start in order to be born. Cynthia andturnstoward crying starts hermotherwhogives her aloving hug.Dr. Vas speaks ninemonths I’vethank you forthewonderful hadofyou growing inmywomb.” Cynthia Dr. Vas you Cynthia insaying,“Thank thatyou have chosenmetobeyour mother, and know how tomove, how canal.”At topass through thispoint,Regina thebirth joins ”You willsignaltoyour you mothertheonset ofyour possesstheknowledge. birth; You healthy, clever andsweet baby.” Cynthia’s faceturnsabitworried,soDr. Vas continues, you will show yourself to your parentswill see that you are and others and everybody a any trouble, you are ahealthy, beautifulandclever baby. You willsoonbeborn andthen aboutit;it’sworry withoutreason. Believe heisworrying me,you nottrue; willnothave Vas obstetrician isgoingtosaysomethingwhichwillshockyou. Don’t tellsthem,“The growing Dr. andtheassumingofcontactwithmotherher impendingbirth, she whispers,“It here.” iswonderful Following Dr. Vas’ suggestionsregarding healthy Dr. Vas herintenseexperience.Answering hisquestionofhow couldobserve shefeels, her togothefetalage,earliestphaseoflife,step-by-step inherimagination. of hermotherwhoisembracingher, andfrom thatmomentitseemsmostnaturalfor THT forthefirsttimeinherlife. Turned onthelap onherside,sheislyingcomfortably andthistimeinvolveand birth more successfulcopingwiththesituation. therapist, Dr. Vas thinksthatRegina andCynthia could jointlyre-experience pregnancy was applied. While listeningtothisstory, Cynthia onthesofa.As fiddlednervously wasexpectedandaCaesariansectionposition inthewombbefore adifficult birth birth, systembestrengthened withmedication.AsCynthianervous hadn’t assumedthecorrect examination indicatedasmallcranialsize. The obstetriciantherefore ordered thatthe Regina washospitalized fortwoweeks priortoCynthia’s duedate,as the ultrasound Regina revealed something Cynthia hadnotknown previously: whenexpectingCynthia, it.During ajointinterview,hypnosis andwaskeenonjoininghermotherintrying child andisgifted,withambitionsofbecomingamusician.She showed interest in for around ayear, communicatinggenderidentityproblems thisway. She istheoldest herself forwhomsheoriginallysoughthelp. she hadbeenexperiencingrecurring panic-likestatesthoughitwasherdaughterandnot within a“caul” ofanxietyever sinceherchildhood.During theweeks preceding hypnosis, toReginabirth afteraprolonged labor. Regina wasborninthecaulandshehaslived of theoccupyingforces. Her mothergrew upinanemotionallyfrozen climateandgave on hermother’s sidewasphysicallyandmentallyabusedduring World War IIby soldiers caught her, pulledasackoutofherbodyandthrew itintothesky. Regina’s grandmother hooded horsemanwaschasingher. She toescapehimbutthehorseman wasrunning children. On thenightpreceding hermiscarriageshehadadream inwhichablack- Treatment of Trichotillomania withMother-Daughter THT (therapist:Dr. Vas) P. JÓZSEFVAS, MD,ECPANDNOÉMICSÁSZÁR,PhD, The therapist’s intuition suggeststhatCynthia isready togoaheadandexperience Regina, 38,hadamiscarriageduringherfirstpregnancy tothree butlatergave birth Her daughter, Cynthia, age14,hasbeenpluckinghereyebrows andeyelashes through skinreceptors; proprioceptive impulsesbeingprocessed by receptors ofskeletal become conscious via the following: tactile and nociceptive information being processed via bodilycontactin THT. The functioningofthefetalprimordial systemmay nervous processes tobepreconscious orunconsciousinthenormalwakingstate canberelived situation, anexperiencethat couldhardly beexpressed inwords. individual hypnotherapythey hadnever relived whattheyhad experiencedinatandem a separateexperiencefrom THT. Participants in THT have regularly mentioned thatin mother-fetus relationship inthecontextofindividualpsychotherapy canbeconsidered reason whyrepresentations ofthistouchcannotbemade. The experienceofimagining to function even beforesystem evolves which is the the central nervous in the embryo, the sameasbeingtouchedinactuality. Within the THT modality, touchingisthought touch. We suggest that merely imagining being intimately touched cannot be considered traumas thathave beeninherited by successive generations(Vas &Császár, 2011b). as Cynthia’s matrilinealline,includinghergrandmotherandmother, suffered serious asanexampleofhowcase serves intergenerationaltraumascanbetreated with THT, identity asa woman by resolving her self-depreciation caused by prenatal trauma. This musician. She now feelswell andreports nosymptoms. THT hasenhancedhersenseof Cynthia schoolsinorder toreach switched secondary heroriginalgoalofbecominga imprinting withthefatherbecameoverwritten. Two years afterthatsingle THT session ofthetherapythatearlythe heavyfeelings,anditispossiblethatwasinthispart looked intoeachother’s eyes. Cynthia sobbedwhilehugginghermotherandresolved and soon.In experienceofthe thebirthing THT session,itwasRegina andCynthia who imprinted relationship. Cynthia followed always her sat father next everywhere, to him, looked intoherfather’s eyes, whichmightgive aplausibleexplanationfortheiralmost offtoallowfather first,whotookhisshirt askintocontact. Thus, Cynthia hadfirst thebaby wasputonthechestof was underageneralanestheticandafterthebirth revealed to the therapist that when Cynthia was born by Caesarian section she herself had always kept romantic relationships at a distance. Six months after hypnosis, Regina period. menstrual Two monthslater, shefellinmutuallove withaboy even thoughshe who wastheonlygirlinherclasshadnotyet “becomeawoman”, hadherfirst of physicalintegrityandthereby herself-concept. Moreover, twoweeks later, Cynthia, was hisominousprediction that,becauseofRegina’s worries,underminedCynthia’s sense surprise. Symbolically it was the “aggressive” obstetrician whom she “sent packing” as it mother thatwhentheboy teasingheratschool,shesenthimpackingtoeveryone’s started The hypnosistookplaceon a Saturday andthefollowing Monday, Cynthia toldher occurred duringtimesofstress only. Moreover, Cynthia begantolookmore confident. following week, Regina reported thattheeyelash-plucking becamelessfrequent; now it harassed heratschoolthattime.Cynthia’s graduallycomestoanend. crying The back from infancytothepresent, sheentered herclassroom andpunchedtheboy who feelings. They are bothdeeplymoved. too.hug. Regina In iscrying, Cynthia’s thetherapistsensesarelease oftraumatic crying, We systemfunctioning whichisusuallysuppressed propose by thatearlynervous ego A cornerstoneofour hypothesis is the wide experientialandmeaning dimensions of When asked,Cynthia explainsthatduringthede-hypnosisexperienceofhercoming The Theoretical integration of Touch,integration The Theoretical Tranceand Transference TANDEM HYPNOTHERAPY 81 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 82 International Body Psychotherapy Journal The Art and Science of Somatic Praxis as co-therapist with a relative of hers. Thus, she was the first person to ever gain self- context, including thetherapist.I,Dr. Vas, onceaskedNoémi Császár togointotrance counter-transference intandemandtherapeutic evolving amongtheparticipants functions. kind ofattachmentmaydevelop, earlydeficitsofstress-coping whichcanregulate very warmth, andsecurity. Moreover, aviscerallevel ofattunementoramother–infant the experiencesthatoriginated from jointbodilycommunication, creating calmness, sensorimotor attunementbetween thetandemparticipants. The therapistbuildsupon the development ofajointemotionaland experiential focus,whichcanleadtoa behaviors, sometimes even the most minute of motions, mutually emphasizeinvoluntary focus onthe“meeting points” oftheirexperiences.In thisway, autonomoussignals, whereby intrance,insteadoffocusingtheirattentiononthemselves, theparticipants intandem. participants The hypnotherapist prompts aspecificdivisionofattention, mutual physiological,emotionalandexperientialattunement isestablishedbetween the therapist’s next step is to create a trance state. During induction and trance, a rapport, or perinataltraumaticexperiencewithasenseofacceptance, securityandlove. This positive sensorimotor associative experience can be regarded as replacing the prenatal sensorimotor level thepositive experiencesofoncebeinginthewombpriortotrauma. the amnioticfluidthatwasonceexperienced. Thus THTcanhelppatients relive on a touch thatisfeltby thepatientduringtrancecanbeanalogized withthecaressing of inskin influence thosetraumaticexperiencespreserved receptors. Thetandem-partner’s traumatic experiencesthatare processed at an associative level. So touchin THT canalso (Perttheory &Marriott, 2007),allofourbodycells,especiallyskinreceptors, preserve all ofsensorimotorandvisceralexperiencesare collected.According tothebodymind ego-functioning. oneness−experience”. That isthereason whyitiscalled“secondary of life.However, ofthepatient’s thistypeofexperiencecanonlybeconsciousby virtue periodimplicit sensorimotorsomaticandvisceralmemoriesfrom theearliestembryonic to bethisstream, whichmeansbeing atanassociative modeofexperiencing,recalling transforming intothisstream, thepatientthenexperiencesatabodilylevel how itfeels as identicalwiththestream. On thecontrary, ifthetherapistaskspatienttoimagine suitable foradissociative modeofexperiencingbecausethepatientdoesn’t seehim/herself methods, thetherapistcanaskpatienttoimagineastream. The stream isseentobe (Oakley, 2008).In the courseof the therapy conducted by guided affective imagery experiences from consciousness to create separation between outer and inner reality system develops, ego-consciousnessoccurs,whichisviewedasbeingabletodifferentiate oneness−experience”.Afterthecentralnervousobject (outerreality), itiscalled“primary fordistinguishingandseparatingsubject(innerreality) andis seentobenecessary systemdoesnotevolve beforeAs thecentralnervous there isego-consciousness, which and experiencesconsciousnessmaybetreated asonewithoutanyego-reflection. other,mode ofexperiencing.Every momentiscontinuouslyassociatedwithevery sensory systemworks thesamewayasitworks inadulthood. nervous is likelythattheembryonic andofothervisceralorgans(Chamberlain,1993,pp.of theheart 9-31;Piontelli, 2010).It muscles; andemotionalinformationbeingprocessed by theautonomousneuralnetwork P. JÓZSEFVAS, MD,ECPANDNOÉMICSÁSZÁR,PhD, Acceptance, securityandlove canberegarded astheessenceoftransference and While theclientandco-therapistare inphysicalcontacttouchingeachother, the To ofassociative functioninginwhich betouchedalsoseemstofallintothecategory It isproposed thattheearliestsensorimotorlevel offunctioninghasanassociative mutual attunement, whichiscalledthe“communication ofontological love”. The aimofthemethodisto replace therepetition oftraumaticexperience with positive consequences originatingfrom relational traumasof theprenatal andperinatalperiods. level butalsoinreality,imaginary withthe possibilityofeliminatingentirely pathological can facilitatetheresolution oftraumaticexperiencesfrom thepast notonlyonan marked events. The physicalpresence andmutualtouchesofthoseinthejointtrance holistic, existential-ontological approach thatfocusesonthemeaningof lifeandits to transpersonaltherapies.Instead ofbeingsymptom-oriented, itischaracterized by a efficacy, more detailedresearch of THT isplannedinthenearfuture. shown are inthearticle notclosed,sotheresults we have are preliminary. To understand then theindividualtherapycanbecontinuedafterresolving them. The twocasevignettes individual psychotherapy hascometoanimpassebecauseofpre/perinatal traumasand relational life.For difficultiesoftheireveryday thisreason, THT canbeusedwhen that aidspatientswhoneedtousetheirpower towork through theintrapersonaland healing (Gravitz &Gerton). We suggestthat andcatalyticmethodTHT isacathartic sexual urges. homophobia; manifestparanoidanxieties;hostility;anduncontrollable aggressive or of psychosis; grave aversion tophysicalclosenessandtouching,forexamplemyso-or self-boundaries whichthereby posetheriskoflosingsensereality andanoutbreak spiritual andpsychological strength. also becapitalized onforitspotentialgainingasenseofunityandthusincurring bipolar affective disorder, personalitydisorder, addictionorcriminality. drug THT may result inseveral typesofpathologies,such asanxietydisorder, dissociative disorder, of the ontological splitting involving the dilemma as toone’s right to exist which might exhibiting behaviordisorders suchasaphobiaortic. the motherduringpregnancy ofthechildunderconsideration;or orbirthing own motherhood(e.g.“Iamabadmother”); physical/mentaltraumawhichaffected well asofmaintainingpsychological boundaries. capable of expressing their respect to all members involved in tandem hypnotherapy, as acceptance. To bepracticed,thismethodrequires highlyqualifiedprofessionals whoare family therapy, transference issuesare tobehandledwithgreat tolerance,respect, and and theco-therapist,incontextoftherapeuticdyadwithpatient.As or ontological love conditions both between arethe therapist viewed to be necessary a collegialconsultation.It tostatethatacceptance,securityandspiritual isimportant experience during THT. Afterthesessions,we discussedallthedetailsinframeof From Freud’s timeon,there hasbeenmuchdebateabouthow catharsisworks for THT iscontra–indicatedby anypsychological statewhichinvolves severe weakness of twinsisindicatedifaimingattheresolutionThe jointtranceofnaturaland/orvirtual Natural mother–child THT isindicatedinthecaseofanegative evaluation ofone’s Finally, method,whichwasdeveloped byTHT isanew theauthors,andbelongs Indications andContraindications Conclusion TANDEM HYPNOTHERAPY 83 International Body Psychotherapy Journal The Art and Science of Somatic Praxis 84 International Body Psychotherapy Journal The Art and Science of Somatic Praxis Cheek, D.B.(1993).On Telepathy, Clairvoyanceand’Hearing’ inUtero. The Cheek, D.B.(1986).Prenatal and perinatalimprints:Apparent prenatal consciousness Cheek, D.B.(1980).Ideomotor questioning:revealing anapparently valid traumatic Chamberlain, D.B.(1993).Prenatal Intelligence. In T. 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Table of Contents:

4 Editorial Jacqueline A. Carleton, PhD

ARTICLES

8 Sense and Sensibility in Supervision Sibylle Huerta Krefft, MA, ECP (Translated from the German by Elizabeth Marshall)

15 Bridging the Split: Integrating Psychodynamic and Body-Centered Therapies. Claire Haiman, PsyD.

27 A spacious life Salita S. Bryant, PhD., MFA.

28 Broken Boundaries, Invaded Territories - The Challenges of Containment in Trauma Work Morit Heitzler, MSc

42 Yoga Based Body Psychotherapy: A Yoga Based and Body Centered Approach to Counseling Livia Shapiro

56 Expanding the Dialogue: Exploring Contributions from Energy Medicine Debra Greene, PhD

74 Tandem Hypnotherapy P. József Vas, MD, ECP and Noémi Császár, PhD, ECP

e uropean a ssociation for b ody- p sychotherapy EABP

Journal (ISSN 2169-4745)