Body Awareness as an Antidote to Therapeutic Burnout

A Process Work Approach

By Jan Dworkin, PhD., and Robert King , M.S.W.

Since the inception of Western psychology, the body has been recognized but undervalued as a source of information about psychic life. Freud, in his classic study on hysteria, established that inexplicable physical symptoms have psychological origin and meaning. Reich extended Freud’s theory and determined that the body expresses one’s characteristic attitudes towards life. He was an innovator who worked directly with the body in order to help his patients free themselves from muscular armour which inhibi­ted their spontaneous liveliness. These early schools spawned off­shoots such as Gestalt therapy, Bioenergetic analysis and Hakomi; holistic approaches which include the body as an integral aspect of personal growth work.

However, most of mainstream psychology still considers the body only incidentally. Many of the people who have the time, resources and inclina­tion to focus on personal development, are disconnected from body life, resulting in stress, psychosomatic illnesses, chronic fatigue syndromes and general burnout. These various ailments, so common to western men and women living in post-industrial societies, highlight a collective denial of the body and its re-emergence in shared symptoms.

Process-oriented Psychology, also known as Process Work, offers a unique orientation to viewing and working with the body. Process Work borrows heavily from C.G. Jung in its philosophy: life has a purpose and potential for wholeness which can be discovered by exploring the uncons­cious; dreams are more than just repositories for unconscious phenomena, they offer direction, guidance and insight. Dr. Arnold Mindell, originally a theoretical physicist and later Jungian analyst, extended Jung’s teleological perspective to include the body. He discovered that the body dreams as well as the mind. The body expresses its dreaming by manifesting symptoms, spontaneous movements, and illnesses. Mindell labelled this phenomenon “the dreambody” an unconscious information pattern seeking awareness.

This article demonstrates how Process Work, through its focus on dream-body awareness, can be helpful to clients suffering from physical symptoms as well as to therapists dealing with stress and burnout. Mindell tells us that “having body problems is like having dreams. It’s healthy to dream, just as it is to have your body producing symptoms. Being ill … is not a sign that you are bad, sick or unconscious, or that you have sinned against God. It is first and foremost a sign that you have a powerful dreaming process happening. In fact, the stronger the symptom, the more powerful the individuation at a given moment.” (Mindell 1992, 27). Process work uncovers meaning, direc­tion, information and new life by focusing on the body. Although it may sometimes lead to spontaneous changes in body feeling and state of health, Process Work is not a healing paradigm. It transcends the Cartesian split between psyche and soma, health and illness, by focusing on ongoing aware­ness and evolution as opposed to causes, origins, outcomes and healing.

Unlike many forms of body therapies, Process Work doesn’t stay exclus­ively with the body. Work on physical symptoms often brings one into the realms of relationship work, creative movement and dance, imagination and meditation, family work and social action, as the dreambody reveals itself. We are becoming increasingly aware of the connection between body experi­ences and social issues such as racism, sexism and homophobia.

Consider the case of Ted, a white male in his early thirties with skin cancer. The setting is a therapy group for people dealing with serious and life threatening illnesses. Ted wants to work because he is lonely and feels that the visible indication of cancer and what he considers his “ugliness” will impair his chances of ever finding a partner. He is sure that his blemishes will get in the way of physical contact and intimacy.

A process worker is more interested in subjective, sensory-oriented, phenomenologically based experiences, than in the static or medical descriptions of symptoms. Subjective experiences manifest in various sensory channels such as seeing, hearing, proprioception (body feeling) and kinasthesia. In this case the man’s subjective experience of his cancer was both visual and proprioceptive. He sees and feels the blemishes. They look “ugly” and they feel hard and rough to his touch.

As he rubs the spot on his arm he says, “I look in the mirror and see these spots and I want to avoid them. I say this is not me.” Such a statement reveals that Ted is disavowing an unwanted and disturbing aspect of him­self. The disavowed experience is the process worker’s gold or “royal road to the unconscious.” There is something in Ted which is deeply disturbing to his conscious identity. It is hard and rough and unattractive to him, and has taken the form of skin cancer. He is sure that others would be as repulsed as he is. This is nature calling for investigation and the key to Ted’s wholeness.

The ensuing process work revolves around the conflict between his iden­tity as a kindhearted man who keeps things inside and hides from life and a tougher, rougher more aggressive and visible side of his personality. Ted had witnessed his father’s violence against his mother as a small child and had promised himself never to become like his brutal father. As a result he had repressed his own instinctive, rough and physical nature, which he con­sidered ugly. He spent much of his life depressed and isolated, living in constant shame and fear.

As Ted began exploring his roughness he approached a punching bag, at first tentatively and then punching with full force. In a role play he could use his force to stand up to the shaming figure who put him down and attacked his integrity. What he originally feared was a potential for violence turned out to be a powerful, tough man with a deep desire to fight for the rights of himself and others. He got in touch with a fighter who was engaged in a life and death struggle to free himself from the prison of shame so that he could stand tall and proud and live his full masculine self without being abusive. The information in his symptom seemed to be an antidote to his sense of depression, ugliness and burnout.

Numerous experiences in Process work reveal that when we do not live our wholeness we feel lethargic, bored and lifeless. But often, as in the case of Ted, living our wholeness means learning to follow our body rather than to control or repress it. Many of our religions teach that the body will sin or lead us astray. Following nature is a great risk: it means embracing aspects of ourselves which do not go along with our familiar identities and collective standards. Controlling, inhibiting or ignoring nature often sets up stress and burn-out.

Burnout is especially prevalent in the helping professions. “Helpers” are trained to focus on others and develop professional styles which reflect this identity. Process Work compensates mainstream therapeutic trainings by en­couraging students to notice, value and use their own body experiences when working with people. This requires a huge amount of skill and aware­ness.

A person’s energy level depends at least as much on their dreaming pro­cess as on whether or not they had a good night’s rest. There is no way to guarantee that a therapist will have abundant energy upon demand. How­ever a therapist who follows nature by attending to her body experiences develops a personal style which reflects her unique brand of energy. If an active and energetic therapist forces herself to sit still and listen she is likely to develop body symptoms that express her body’s repressed liveliness. Such symptoms might include rashes, fidgeting, nervous ticks or a wander­ing mind. The client might notice the therapist’s distraction and feel hurt, ripped off or even abandoned. Such a therapist might experience less burnout if she followed her natural tendency towards activity in her therapeutic work.

Therapists who ignore their body experience in favour of thought and analysis or who disregard their inner life in favour of relating may some­times experience burnout. I remember a trainee who learned to get out of her chair, find her dance and discover how this inspired her client’s process. Another learned to use his inner feeling states as a barometer for the client’s emotions.

We consulted recently with a therapist who was often tired when he worked and noticed that he leaned back in his chair, sometimes almost nodding off to sleep. This made him quite uncomfortable since he felt his sleepiness made him less helpful to his clients. He had been traditionally trained to interpret and offer insights but he was burned out and tired of helping people. We encouraged him to use his body awareness with his clients and to discover what his posture was trying to tell him.

While working with a long term client with whom he often felt tired, the therapist focused on his own body. He used his awareness to exaggerate his reclining posture and to feel it even more intensely. Stretching out, he felt relaxed and present, but quiet and not necessarily helpful. He heard an inner voice which demanded that he DO something intelligent. “Your mere presence isn’t helpful,” said the critic, “you are just being lazy and selfish, after all, you are being paid for this.” The therapist stayed with his experi­ence and found himself enjoying the moment and feeling radiant and relaxed.

The client, a businessman and chronic workaholic had recently had an accident in which he had broken his foot and was laid up. He was doing all sorts of physical therapies to speed his recovery but his healing was taking longer than he had hoped. He followed all the programmes which his physical therapists recommended; in counselling he was a “good client”, generally doing what he thought the therapist would expect.

Through the process, the client discovered that he too could not relax and be present without feeling insufficient. Like many white men, he was trained to succeed and achieve in order to feel self worth. By following his own body experiences, the therapist modelled a new and radical behaviour for the client. In fact, by doing his own work, the therapist seemed to be picking up a very important part of the client’s process. The therapist opened up to his own body and got information which the client needed!

This implies a kind of field thinking: information is available everywhere and seeks discovery. Our individual body experiences are not only personal. The client’s process may manifest through the therapist’s dreams and body experiences, through synchronicities and in the world. When information about the client appears through the therapist’s experiences it is known in Process Work as “dreaming up”: the therapist becomes part of the client’s dream field and through their signal exchange picks up information which also belongs to the client’s dreaming process. (More information about dreaming up will be available in Joe Goodbread, “Dreaming Up Reality”, to be published in 1995.)

This therapist slowly learned to relax more with all his clients. He found himself enjoying his work and feeling more energized. His clients seemed to be getting more as well – he had more to give when he let go of trying and followed his body experience instead. In this case his body experience, as manifested in his posture, helped him to become whole, challenge a pro­fessional norm and resist a cultural expectation about male behaviour.

Here we see the connection between bodywork and social issues. For some of us it is easier to cope with stress and burnout than to face the challenges to identity and culture which our body experiences demand. The more we include the body in psychotherapy, the more the profession will be called upon to support individuation rather than adaptation and social change over consensus reality. Process Work is one approach which is attempting to embrace this calling.


Mindell, Arny and Mindell Amy. Riding The Horse Backwards. Penguin Books, 1992.

Process-oriented Psychology or Process Work, developed by Dr. Arnold Mindell, is a comprehensive and innovative approach to physical and psychic phenomena which integrates individual, relationship and group work into a single theoretical frame­work. Mindell, originally a theoretical physicist and later a Jungian analyst developed his theory while living in Zurich, Switzerland where he focused mainly on work with individuals and families in both normal and extreme states of conscious­ness such as comas and psychotic states. He later brought the work to the United States, where he concentrated on large group work, conflict facilitation and work with racial, political and social conflicts. Currently, a training in Process Work is available in Ireland. For information about it please contact Brid Commins 01-8251629 or Nuala Rothery 01-2956163.