There is more wisdom in your body than in your deepest philosophy.
Nietzsche
The foundations & theories from which Body Psychotherapy has evolved:
Those personalities of the psychoanalytic world from the late 19th century and early twentieth century, including Freud, Adler, Groddeck and Ferenzci, laid the foundations for BP, since they researched and recognised the psycho-physiological basis of neurosis. Freud reflected extensively on the connection between psyche and soma and even declared that the ego is a “body-ego” and, presumed that psychoanalysis would someday be grounded in physiology and biology. Also, Freud’s conceptualisation of the libido, within a context of homeostasis, is more aligned with biology and physics than with psychology. Noticing his clients’ strong rebellious motivations to liberate their bodies’ energies, Freud used a variety of techniques, including massage.
Adler, president of the Psychoanalytical Society of Vienna, agreed with Freud that the client’s soul not only influences his behaviour, but will also have an impact on the physiological indicators that generate his symptoms. He wanted to develop a psychoanalysis in which work on the physiological dimensions would permit the treatment of the psyche and vice versa.
Like Adler, Groddeck wanted to create an approach adapted to the needs of his patients. Also called ‘the pathfinder of psychosomatic medicine’, Groddeck proposed a ‘psychosomatic’ psychotherapy that approached the patient in their organismic whole.
Both Wilhelm Reich and Ferenczi were influenced by Groddeck, who allied deep massage with verbal interventions. However, it was Reich who became the most important pioneer of BP. In his clinical work with Freud, he concluded that attitudes were embodied and revealed themselves in posture, subtle movements, muscle tone, and breathing patterns. Reich recognised that all neurotic symptoms also have a physiological and physical aspect. Body and mind interact with each other and mirror each other; if the mind forms a conclusion, the body reacts. His concept of ‘Character Armour’ describes how habitual physical tensions are protective and repress what we cannot deal with, protecting us from re-experiencing emotional pain. However, they also restrict us in experiencing pleasure, spontaneity, and joy!
Furthermore, Reich observed the vegetative or autonomic nervous system during therapy and noticed that the sympathetic and parasympathetic reactions were related to character resistances. It was important for Reich to discover those involuntary responses beyond the mind’s control. Such vegetative changes he could observe in individuals’ involuntary movements and expressions, their breathing, changes in skin colour or heat, and muscle spasms or twitches. He established that those physical patterns were identical to the psychological ones and started ‘Vegetotherapy’, which involves working with the physical manifestations of emotions, which Reich regarded as the ‘character-analysis of the body’.
Later, Reich realised that energy can be bound by chronic muscular tension and started studying ‘bodily’ attitudes. He argued that without addressing the patient’s underlying ‘Body Armour’, the therapeutic process may stagnate at the level of mental understanding. He also believed that emotional health is related to the capacity for full surrender in the sexual act, also called ‘orgastic potency’, which he developed further into ‘Orgone Energy’. Finally, Reich claimed that both psychological and psychosomatic symptoms need to be approached with the underlying character patterns, which infiltrate the entire body-mind ensemble, reaching down into our biological mechanisms (e.g., our metabolism, autonomic nervous system, and breathing).
Reich developed his own type of ‘body psychoanalysis’, where embodied impulses and perceptions were verbalised through free association. An international post-Reichian movement of BP started in the 1950s, either stemming directly from Reich’s work or at least owing to it, and in the context of an increasingly humanistic movement that began at that time. Alexander Lowen founded the ‘Bioenergetic Analysis’ (aka ‘Bioenergetics’) in the early 1950s; his associate, John Pierrakos, developed ‘Core Energetics’ in the early 1970s; David Boadella, for many years the pre-eminent British follower of Reich, originally trained in Vegetotherapy, then went on to develop ‘Biosynthesis’ in the early 1970s; and, finally, Ola Raknes, who had trained and worked very closely with Reich during his years in exile in Norway (1934-1939), practised Reich’s ‘Vegetotherapy’, which his student, Gerda Boyesen, later transformed into ‘Biodynamic Psychology and Psychotherapy’.
Research
Attention to the body has become increasingly unavoidable in psychotherapy today. Interest in and general awareness of the body is growing amongst clients who look to supplement verbal psychotherapy with a more holistic approach to their issues. Much of the pain and suffering that brings people to counselling and therapy in the first place has to do with bodily symptoms such as eating disorders, sexual difficulties, hyper arousal, anxiety attacks, physical tension and stress. The heterogeneous field of BP provides a range of unique contributions for the treatment of mental disorders. Practice-based clinical evidence and empirical studies point towards efficacy, particularly for those disorders with body image aberration and other body related psychopathology (Röhricht, 2009).
Some of the most recent research on body-oriented psychological therapy suggests that BP is particularly relevant for those disorders with body image aberration and other body-related psychopathologies, but also for mental disorders with limited treatment response to traditional talking therapies, such as somatoform disorders/medically unexplained syndromes, PTSD, schizophreniform illnesses, personality disorders and eating disorders. Current practice-based clinical evidence shows that BP can reduce depressive and anxiety symptoms, somatisation and social insecurity. Patients undergoing BP appear to benefit from a reduction in muscular tension, and increases in body satisfaction, self-perception and self-esteem (Röhricht, 2009). The results of recent empirical studies on body-oriented psychological therapy for patients in recovery from child sexual abuse (Price, 2005), with fibromyalgia and chronic pain (Gard, 2005), with negative symptoms in schizophrenia (Röhricht and Priebe 2006), or suffering from PTSD and chronic pain (Price and McBride, 2007 ; Hyerle and Kivlahan, 2007) suggest that the therapy can reduce specific symptoms and can increase body awareness and autonomy.
Despite these promising findings, the evidence base needs developing in order to get BP recognised by mainstream health services, and strong academic links are crucial to support practitioners in their efforts to evaluate their clinical work in systematic research.
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