In Practice……

In Practice will be a regular feature of our Journal where we
 invite other psychotherapists to share an issue or dilemma 
arising directly from their practice which stimulates thinking 
and discussion.

In this issue Ger Murphy looks at the use of expressive bodywork.

A dilemma I encountered recently questioned me as to the use of expressive
 bodywork techniques with clients where a strong sense of ego boundaries is not 
yet in place.

A client, Ms.D, with whom I have worked for some months, was moving from 
feeling a victim of others’ hostility and violence (a regressive pattern) to owning 
how she in the present felt hostility and violence in her. This helped her shift
 from a depressed state to an enraged one. When we came to explore how she 
could express her rage she seemed unable to act it out using therapy room 
materials: racket, cushions, etc., and to talk about it was insufficient and
 frustrating to her. I wondered whether this may have been how she was
 expressing her rage here in the session i.e. “not being a ‘co-operative’ client”, and
 needing to resist my offer.

However, Ms.D. continued to state that in fact she needed a victim, needed 
someone to suffer. I initially saw this as indicating her need for retribution for the
 pain she felt. However, I realised, with her help, that it was deeper than this. Ms.
D. states, “how can being angry alone make sense? I disappear when I’m on my
 own”. It became obvious that expressive bodywork aimed at the release of anger
 confronted her with a fear of non-being, a threat to her sense of existence, and an
 as yet intolerable degree of separation-anxiety.

Winnicott and others ascribe such feelings to an unsatisfactory early
 mothering experience where the sense of self cannot manifest due to the absence 
of mirroring and holding. The therapy can later attempt to provide some of these
 elements as a corrective experience.

It can be seen then, that a body oriented tool coming from a humanistic 
psychotherapy stance can be a valuable diagnostic tool in developing a way of 
understanding with a client, which emanates from a more analytic framework.
 Similarly integrating these models with this client as example may give direction 
to the work in that Ms. D. may later feel able to experience and release her anger 
with the necessary holding and mirroring having been undergone. Such an 
interplay between humanistic and analytic tools is, I believe, a rich area of
 development which can greatly benefit the work.