http://hdl.handle.net/10401/5951 Avances en Salud Mental Relacional Advances in Relational Mental Health ISSN 1579-3516 - Vol. 12 - Núm. 3 - Diciembre 2013 Órgano Oficial de expresión de la Fundación OMIE Revista Internacional On-Line / An International On-Line Journal THE EVOLUTION OF AUTOGENIC PSYCHOTHERAPY IN SPAIN Luis de Rivera, MD, FRCPC. Professor of Psychiatry www.psicoter.es It is difficult to understand the development of autogenic training in Spain without realizing how devastated Spanish Psychiatry was after the Civil War. Most of its prominent practitioners were forced into exile. Mira-Lopez, the inventor of the myokinetic test, went to England. Angel Garma went to Argentina, where he soon became the president of Buenos Aires Psychoanalytic Association. Miguel Prados went to Canada, were he co-founded McGill University Psychiatry Department. Tosquelles went to France, were he was soon the director of a most progresist psychiatric hospital. De Ajuriaguerra became University Professor and the Chairman of Genève´s celebrated Psychiatric Services... Spanish Psychiatry became stagnant for decades, but Spain´s loss became the World´s gain. When Schultz´s Autogenes Training was first translated into Spanish in 1954 (1), there were few high ranking professionals available to take the lead. An exception was Ramón Sarro, who in 1958 organized an International Psychotherapy Congress in Barcelona, attended by Schultz himself. Soon, autogenic training was of notice to medical specialists, such as the internist Rof-Carballo, the pioneer of Psychosomatic Medicine in Spain, and the gynecologist Aguirre de Carcer, a pioneer of natural childbirth. Meanwhile, Lopez-Ibor, a brilliant clinician and a fierce opponent of psychoanalysis, opened his Chair in Madrid University to a young Colombian neuropsychiatrist, Alfonso Caycedo, who in October 1960 founded the first Department of Clinical Sophrology in the Madrid Provincial Hospital. Little is known of Caycedo´s teachers and training, but his method constitutes an interesting amalgamation of autogenic training with hypnotism, yoga and a few original contributions. Like Emile Coué´s autosuggestion method in the XIX century ("Every day, in every way, I'm getting better and better"), Caycedo´s “Dynamic Relaxation” took its surroundings by storm, spreading soon to Catalonia, France and, of course, South America. Like Coue´s, its fame was short-lived. However, it left the medical and psychological professions with the misleading perception that autogenic training was a soft kind of hypnosis, of marginal scientific interest and of minor use, at the most, an adjuvant treatment for somatized anxiety. Lack of proper instructors, excess of amateur practitioners and bold unsubstantiated claims brought relaxation techniques in general into disrepute, and finally into oblivion. © 2014 CORE Academic, Instituto de Psicoterapia -1- http://hdl.handle.net/10401/5951 The evolution of Autogenic Psychotherapy in Spain Fig. 1 Nomination of ICAT member representing Spain It was not until the mid-seventies, with the return of young professionals trained abroad, mainly in North-America and in Switzerland, that autogenic training took a new turn. The Spanish Society for Autogenic Psychotherapy was founded in 1979; in 1995 changed its name to Spanish Association of Psychotherapy, but kept in its By-laws the “study, application and development of autogenic approaches” as one of its aims. Jose Guimon, a disciple of De Ajuriaguerra, founded in Bilbao the first ASMR. 2013 - Vol. 12 - Núm. 3 -2- http://hdl.handle.net/10401/5951 The evolution of Autogenic Psychotherapy in Spain University Chair of Psychiatry in the Basque Country, where he introduced “psychotonic reeducation”, his teacher´s version of autogenic training. Soon, he invited his long-time friend and colleague Luis G. de Rivera, a close disciple of Wolfgang Luthe and the member of I.C.A.T.1 representing Spain, to impart regular seminars on autogenic training in the Bilbao Institute of Psychotherapy. Jose Guimón was also the director of the first Spanish doctoral thesis in Autogenic Therapy, read in the University of Bilbao, in which the studies by Luis de Rivera on the treatment of Temporal Lobe epilepsy with autogenic training were reported (2). In 1986 Luis G. de Rivera became the first Chairman of Psychiatry in the University of La Laguna in the Canary Islands, where autogenic training began to be regularly taught to medical students. Several doctoral dissertations were read on different aspects of the method, like Manuel Henry´s Autogenic Therapy of Bronchial Asthma (3), Garcia-Trujillo´s Subjective Experiences during the Autogenic State (4), Rodriguez-Abuin´s Stress Reactivity in Temporo-Mandibular Dysfunction (5), Moron´s Autogenic Psychotherapy and Stress Prevention in Children (6), Salom-Serra´s Introduction of Auto-relaxation techniques in Medicine (7)... Over the last decade, several University postgraduate programs in Clinical Psychology and Psychotherapy have introduced autogenic training in their curriculum. The core of the “Diploma de Formación Superior en Psicoterapia” (Diploma on High Training in Psychotherapy) offered by the Universidad Autonoma de Madrid between 2004 and 2011 was built around the autogenic approach. The current Spanish standard textbook on basic autogenic psychotherapy, sponsored by the UNED and the Spanish Association of Psychotherapy, evolved from the lectures imparted since 1997 in the Master “Psychopatology and Health” organized by the UNED (8,9). Likewise, Autogenic Psychotherapy is regularly present at Spanish Scientific Meetings. International Congresses celebrated in Madrid, such as the X Congress of the International College of Psychosomatic Medicine (10) and the X World Congress of Psychiatry (11) both of which included symposia on Autogenic Psychotherapy, attended by distinguished speakers such as Gastaldo, Wallnofer, Ikemi, Carruthers, Diamond, Pszywyj, Stetter and others. Besides clinical research on epilepsy (12, 13), anxiety (14,15, 16), stress (17, 18 19) and psychosomatic disorders (20, 21, 22, 23), there has been a considerable effort in the extraclinical applications of autogenic training, such as in psycho-pedagogy, in the mobilization of creativity and in the increase of resilience (24, 25, 26, 27, 28, 29). The recognition that the central brain mechanisms activated by the standard autogenic exercises are the same involved in the altered consciousness states induced by oriental meditation techniques prompted comparison studies with these techniques (26, 27, 28, 29, 30, 31). The application of our States of Consciousness Questionnaire (32) is helping to position the autogenic state in the general map of Consciousness States. Autogenic training seems to be the safest and most clinically rewarding of all the meditation techniques studied. It is difficult to ascertain if some severe side effects of oriental techniques are related to the technique itself or to awkward use by questionable gurus, but we have described two cases of psychosis precipitated by the practices of a mystical oriental group (33). Likewise, we have detected surprising training difficulties with some trainees coming from yoga schools, who have to unlearn improper approaches to passive acceptance in general, and to respiration control in particular. Of course, it may 1 The International Committee for the Coordination of Clinical Application and Theaching of Autogenic Therapy (ICAT) held its first meeting in Montreal in 1961 during the third World Congress of Psychiatry. ASMR. 2013 - Vol. 12 - Núm. 3 -3- http://hdl.handle.net/10401/5951 The evolution of Autogenic Psychotherapy in Spain be argued that it is unfair to compare the results of autogenic psychotherapy, which in Spain is a medical and clinical-psychological procedure, with those of the oriental meditation schools, whose aim is enlightenment or some other mystical achievement. This is true, albeit some practitioner may claim that autogenic psychotherapy, especially when the most advanced methods are applied, is a safe vehicle to self-discovery and transcendence. Nevertheless, for the most part, autogenic psychotherapy is taught and practiced as a clinical procedure. Fig. 2. Map of States of Conciousness The term Autogenic Psychotherapy was introduced very early in Spain to cover both basic autogenic training and the most sophisticated advanced techniques (34). This was not a mere terminological preference, but the recognition that the Autogenic Approach contains all the elements of a full-fledged psychotherapeutic procedure. Conceptual comparative studies with psychoanalysis (35,36) and with behavioral-cognitive therapy (37) revealed many coincidences. The flexibility and comprehensiveness of Autogenic Psychotherapy enables its practitioner to integrate other approaches, without damage to its ASMR. 2013 - Vol. 12 - Núm. 3 -4- http://hdl.handle.net/10401/5951 The evolution of Autogenic Psychotherapy in Spain own core. Based both on clinical practice and on fundamental principles of human functioning, Autogenic Psychotherapy is an example of integrative psychotherapy, open to growth by apposition of progressive developments. Psychic education is an important part of the Spanish way of practicing autogenic psychotherapy. “Asking an anxious person to relax is cruelty, unless you teach him how” is one of our best known mottos. The general philosophy is that the trainee-patient is doing his/her own therapy, and the therapist is merely transmitting the know-how and supervising