The focus in all psychotherapies is the same, no matter which orientation the particular therapist follows. The common aim is directed towards the process of well being for the client. Tranferencial issues and true feelings arising in this special relationship between the client and the therapist are also the same. There is, however, one significant difference between non-body-oriented and body-oriented psychotherapy. Body-psychotherapy provides an additional pathway for communication – the physical pathway.
The physical pathway as an additional tool
The mechanism forming the working platform in non-body-psychotherapy is the ‘psychodynamic process’. I am assuming that the reader is familiar with this model. The primary pathway of communication in non-body-psychotherapy is the verbal pathway. In body-psychotherapy we recognise an additional mechanism, the ’physiodynamic process’. This opens an additional pathway, the physical pathway of communication.
The psychodynamic and physiodynamic process always work in parallel
The psychodynamic process and the physiodynamic process always operate in parallel to each other. We can work with these two mechanisms by addressing either one of them at a particular moment. We can also swap between them, and it is possible to move between those two mechanisms in the same session. Working physiodynamically will stimulate the psychodynamic process and vice versa.
Description of biodynamic therapy model
For the reader to be able to follow this introduction to body-psychotherapy, it is necessary to have a basic understanding of the physiodynamic process, and I give a very brief description of it here. I am using the ‘biodynamic therapy’ model
The biodynamic model recognises two energy planes within our organism. The first plane moves vertically and connects us through the two ends of our body, head to the cosmos, and feet to the ground. The vertical energy flow is transpersonal and relates to our spiritual connection, collective connections, etc. There is no time and space boundary on the vertical plane. The vertical zone reaches into regions before conception and after death.
The second energy plane moves horizontally. The horizontal energy flow is personal and relates to our ego consciousness, emotional expression, here and now, time and space, etc.
The vertical and horizontal energy planes are connected with each other and energy flows between them in both directions. A psychoperistalsis, regulates the connection between those two energy planes.
Non-body psychotherapy focuses primarily on the horizontal energy flow. For now, I will focus on the horizontal energy plane, to show how we can work on this plane in body-psychotherapy, and what the dynamics are in the client/therapist relationship.
Every emotional expression is carried out through physiological activity
Every emotional expression is carried out through physiological activity. In other words, we use our body to express emotional energy. We cannot express emotions without our body. We use our voice for verbal expression, our arms and legs for physical expression, we can use our eyes for expression of feelings we have towards another person, etc.
I describe these physiological activities as the physiodynamic process, which operates in direct parallel to the psychodynamic process.
How does the vertical physiodynamic process work?
The healthy pattern
Emotions are triggered by external stimulus through interaction with our environment. The stimulus can be psychodynamic, e.g. we receive some positive or negative attention or feedback from someone else or, physiodynamic, e.g. we experience pain or pleasant sensations through skin contact, taste buds, smell, etc. When the impulse, set off by the external stimulus, reaches the ‘limbic area’ of the brain, the message is passed on through the ‘hypothalamus’ to the ‘endocrine system’ and the emotional upsurge is triggered from the pelvis. The energy travels up the spine, through the hypothalamus to the brain, which in turn gives the instruction to the ‘motor system’ to carry out the expression, using the physical body to do so.
It is important to remember that during this process certain areas of the organism decrease their activity by a large amount. These main areas are the digestive system, the breathing, and the immune system. They regain their full function after the emotional energy is expressed and the organism has returned to a balanced homeostasis.
The unhealthy pattern
In the unhealthy pattern, the response to the external stimulus is distorted or missing, because the energy is blocked somewhere on the pathway described in the healthy pattern. In worse circumstances, the pelvis is frozen and the person would not have a reaction to the stimulus at all, e.g. the person does not feel appropriate emotions to an external stimulus. Because the emotional energy is not fully released, it ‘gets stuck’ within the poison’s body. Full homeostasis does not return and the areas of breathing digestion, and immunity are sometimes permanently working on ‘low key”. This will eventually lead to illness. Depending on how this condition manifests in a person, it can lead to either psychological or physical disorder.
How do we work with these conditions?
All approaches of psychotherapy use verbal communication for exploration of the psychodynamic process, feelings and transference. In addition to the verbal communication, body psychotherapy uses physical communication in the therapeutic relationship between the client and the therapist.
Working with the motor system
Here, the work is done directly with the body through mechanical stimulation. Massage, bioenergetic exercises, or vegetotherapy (mattress work) are primarily used for this type of bodywork. The aim is to increase the flow of emotional energy towards expression, and to either prepare for or support the psychodynamic process.
Working with the visceral system (essential level)
Therapy on the visceral level requires a substantial amount of experience and self- development by the therapist. The area of focus is the time from zero to about one year of age. This time span includes conception, gestation, and birth. There is no language at this time in our life and the therapy is mainly non-verbal and almost entirely physical, which includes physical sense. Communication happens on the gut to gut level, which means, in ideal circumstances, therapist and client have their ego-consciousness surrendered during the session. The skill of the therapist is to be able to surrender ego-consciousness and at the same time to be able to keep the therapeutic boundaries.
Biodynamic theory stipulates that most psychological distortions in our adult life are based on overwhelmingly traumatic experiences during this visceral period. It is like building a house onto a bad foundation. The aim of the visceral work is to repair the foundation without having to knock down the house itself. Once the foundation is repaired, part of the badly built house will crumble and the person is able to re-build a new construction on the stronger foundation. This new house is more suitable for the person and their emotional and creative expression because it was re-constructed under more favourable conditions.
In the following part I will try to describe the dynamic in treatment on the visceral level.
Working with visceral condition
Initial phase – Anamnesis, feedback, treatment plan
Physical examination of the body
If a visceral condition is suspected, a physical examination of the client is the first step in the therapeutic process. Physical examination of the body can increase a useful distance between the client and therapist and also allow the client to detach from their own body sufficiently to be able to look at it from a relatively neutral place. If the client is too close to their physio-psychological state, a connection to the emotional material belonging to the physical condition would be too overwhelming and threatening for the client at this point. The client would need to switch off completely and very little could be achieved within a working relationship.
After the initial physical assessment of about five to ten minutes, an experienced biodynamic therapist will have gained an accurate picture of how the client might regulate themselves emotionally and where their areas of ‘holding’ or ‘leaking’ are. This information is an enormous asset for the therapeutic process. Because the therapist gains this knowledge about the client so fast, if handled wrongly, it can also very quickly destroy the possibility for a future working relationship. It is therefore very important that this information is fed back to the client in the most honest way possible. However, the therapist needs to regulate the amount of information revealed to the client at any one time. Not all of the information can be revealed immediately, because the client may not be ready for it. This stage is extremely important because it will have an influence on the whole outcome of the therapy. It will determine the success or failure of the therapy.
The next step is to relate the identified physical condition to how the client expresses themselves emotionally. During this process the client needs to gain a ’sense of connection’ to their physical condition, or else they will not be able to ’take it on’ (accept; the German word is ‘annehmen’. There is no equivalent in English). This sense of connection will ensure that the client can relate to these conditions as being part of themselves, rather than view them as detached clinical physio-psychological facts. The client will also be able to see a possible purpose of their mechanism, which can give an apparently negative state a positive aspect, with the result that the client is less likely to reject their condition. A possible peril here is that the client might unnecessarily emphasise the roles of helper-victim ‘You are ok (therapist) -I am not ok (client)’. These are projections made by the client, and the therapist must not unnecessarily support them by presenting the client with a perfect model of free emotional expression and compare that to the client’s own inferior mechanism.
The therapist must avoid making interpretations as to emotional connections to the physical conditions. It is more productive to encourage the client to reflect back to their own personal history, making possible connections for themselves. A phrase the therapist might hold during the process of investigation could be I wonder what this (physical) condition is related to’. Holding this phrase or a similar phrase silently in their mind will be received by the client as a permission to explore this area. This process is entirely unconscious and will be made possible after a good rapport between client and therapist has been established. In most cases this rapport will exist in the middle phase of the therapy.
The therapist must never lose sight of the fact that they are dealing with an individual and not with psychological or physiological symptoms in isolation. These symptoms belong to a human being and they have played an important part in this person’s life history.
The client’s body functions in a particular way to aid their emotional and creative expression. A ‘correction’ with the intention to create a ‘healthier’ condition, facilitating a better expression, could prevent the person from expressing themselves in their unique way. A thorough exploration of the present state is therefore necessary to determine what changes, if any, need to be made by the client. These changes need to be what the client wants rather than what fits a picture of a perfect model. The client’s awareness of their condition needs to be heightened, so they can make an informed choice of whether they want a change or not. Any change undertaken after a thorough exploration of the present state will lead the client to independence and well being, and fuller expression of their uniqueness.
Forming the therapeutic alliance
In non-body-psychotherapy we use positive transference as the primary tool to form the initial therapeutic relationship between client and therapist. Working on the visceral level, the primary tool to form the initial therapeutic relationship is working through infantile material from conception to about one year of age. There are no words and only a minimal control of the body’s motor functions (the ego is not developed). The therapeutic relationship at this point is based on the client being the baby and the therapist being the maternal carer. The client is in an infantile-maternal mode, dependent, and needing to be cared for. Because the physio-emotional connection between the client’s emotional expression mechanism and their physical equivalent has been established during the initial step, the client is able to identify their needs and their feelings at this point as ‘old’, and not belonging to the present. They will not project them onto the therapist.
To facilitate an exploration of the client’s visceral world, the therapist must be able to empathise with the client’s psycho-physiological state. A sensitive and experienced therapist will be able to use their own physical body to do this. This means that they will be able to sense what the client might feel or not feel. The main peril here is counter-transference. The therapist must have sufficiently worked through their own material and be sufficiently trained to identify what is their own material and what is that of the client.
Middle phase – deepening the therapeutic relationship
In the middle phase, traditionally we will focus on techniques which will deliberately deepen the therapeutic relationship and transference, with the aim of reiterating the clients conflicts. The client at this point may be looking for the expression of feelings of positive or negative transference, which they develop towards the therapist. This will provide the opportunity to address the conflicts and possibly lead to their origin and resolution. The client, who has gone through an organic physical experience (visceral level) during the initial phase in the therapy, will be able to identify those feelings as infantile feelings (with visceral condition). The recognition and acceptance of those feelings by both the client and the therapist, enables the client to contain and embrace them, rather than projecting them onto the therapist or elsewhere outside the therapeutic relationship. This will facilitate a progressive development towards mature and realistic feelings in the relationship with the therapist.
End phase – fostering independence
In this end phase of psychotherapy, the therapist-client bond, which has developed throughout the therapeutic process, is dissolved. The therapist’s effort is directed towards the client’s independence. In traditional psychotherapy, this could reactivate early feelings of attachment, leading to regression to the infantile maternal bond, from which the client will be unable to break away, which can lead to prolonged dependency.
In this model, the infantile maternal area had been addressed and worked through at the initial stage of the therapy, and fostering independence has been a progressive focus throughout the therapy. The client has now reached the stage of adolescence in the therapeutic process. The process of separation is similar to a child growing up into adulthood and leaving home. Sometimes the client needs to project negative material onto the therapist to facilitate the breaking away. The therapist needs to identify those feelings for what they are, and feed them back to the client to facilitate a positive outcome. ‘Independent well-being’ is the expression used in biodynamic therapy when the client has reached a stage of maturity and autonomy.
Body-psychotherapy is an exciting and organic way of facilitating psycho- emotional change through working directly with the body. Transference plays an equal part in this process, but not a dominant role.
I hope that with this paper. I have been able to show the reader how body- psychotherapy can work in practice and how it might be used. I must stress that not all aspects described here apply to all types of body-psychotherapies. I have used the biodynamic model, because that is what I use and what works for me. Working on the visceral level is perhaps a technique, which is not often used in other body- psychotherapies. while the physio-emotional process described in this article applies to all body-psychotherapies.
The initial presenting difficulty by the client also plays a part in deciding what technique might be used. People with ‘psycho-somatic’ conditions (illness without an organic or known cause) seem to respond particularly well to body- psychotherapy and the visceral level work.
For people with a history of physical abuse for instance, different techniques are used to accommodate their needs. Here, the client is encouraged to explore their body on their own in the presence of the therapist first. The techniques used include guided imagery, and gentle bioenergetic exercises, so the client can gently regain a physical sense of themselves before touch is introduced.
It is always difficult to describe the theory of something which is so physical as body-psychotherapy. This is why, in the training, such emphasis is placed on experiential learning. The trainee therapists need to go through the various cycles of body-psychotherapy themselves before they are able to facilitate these processes for someone else.
Joachim Otto is a founder member of the ‘Irish Institute of Biodynamic Therapy’ (ibt) which offers full training in Biodynamic and Transpersonal Psychotherapy and Massage and short courses for professionals.
For information: Telephone 091-755693, E-mail firstname.lastname@example.org,