Michael Soth - Articles & Papers: Extracts

Current Body Psychotherapy - an integral-relational approach for the 21st century?

Soth, M. (2005) Body Psychotherapy today - an integral-relational approach, Therapy Today, November 2005, Vol 16 No 9

The relevance of Body Psychotherapy for the rest of the field

There are several developments in the field of counselling and psychotherapy which have occasioned this fresh look at Body Psychotherapy and its relevance for the profession as a whole, notably a) the integration of therapeutic approaches, b) the growth of the relational perspective across the whole therapeutic spectrum and c) the impact of neuroscience. In this article I indicate how these three developments have helped Body Psychotherapy move from a reliance on 19th and 20th century paradigms into a 21st century body/mind approach to psyche and psychology which puts the therapeutic relationship at the heart of the work.

The birth trauma of psychotherapy

If we think of the late 19th century and its prevailing zeitgeist as the time of psychotherapys birth, we can recognise how two fundamental pillars of our work are to this day informed and plagued by the paradigms of that era, i.e. our conception of ...

• the relationship between doctor and patient, and ...

• the relationship between mind and body.

In Freuds days, both relationships were imagined as dualistic and hierarchical, with top-down control being required to impose rational order and progressive change on an otherwise unruly, pathological and chaotic primitiveness. His dictum Where Id was, there Ego shall be encapsulates some of these assumptions ¹.

Although the field of counselling and psychotherapy has been ambivalent about these culturally dominant paradigms from the beginning, with our practice relying on counter-cultural intuitions all along, we have never been quite able to extricate ourselves from the legacy of these 19th century assumptions. They constitute the birth trauma of modern psychotherapy and like a birth trauma - underlie the recurring difficulties of our profession, restricting its full potential.

 

The paradigm shift: central control complemented by self-organisation

Neuroscience has been able to have such an inspiring impact on us in recent years precisely because that very same dualistic paradigm used to be at the foundations of their discipline as much as ours. However, some of modern neuroscience has managed to completely dismantle its central dogmas and pull the carpet from under its own feet, re-inventing itself in the process.

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One example from neuroscience, relevant to counselling: the fantasy of the brain as the central computer, managing the organism in top-down fashion, has been deconstructed as a hopelessly inadequate and misleading metaphor. Consequently, insight, understanding, reflection, language (the left-brain) can no longer be seen as the only or even the dominant factors for health or for change in the therapeutic relationship⁴.

The paradigm shift in counselling and psychotherapy: the wound enters the room

The history of our field could be written as the way in which the wound refuses to be segregated into the client and into the mind, breaks down the dualistic fences and enters the consulting room. Where a dualistic psychology locates the problem in the clients mind, to be corrected by the doctors superior consciousness, a 21st century framework recognises the wound entering the here and now of the consulting room in a way which profoundly affects the body/mind of both client and therapist.

In terms of the relationship between doctor and patient, 19th century dualisms have been deconstructed throughout the counselling field for decades⁵ , both by the humanistic movement and by the countertransference revolution in psychoanalysis⁶. Where a dualistic paradigm imagines the doctor as scientist-observer, apparently neutral and uncontaminated by the clients pathology, an increasingly established relational perspective now sees the counsellor as reliant on involvement and participation.

The body/mind dualism, however, continues to plague the whole field across the spectrum of approaches. We know that our mentalist, hierarchical, objectifying conception of the body/mind relationship does not work very well. Such a dualistic paradigm imagines insight and cognition of the rational mind as the main agent of change, whereas modern neuroscience now sees right-brain to right-brain communication in the attachment relationship as foundational for the therapeutic endeavour⁷ .

However, our profession continues to rely on assumptions regarding the mind, the body and their relationship which have long been recognised as out-dated, misleading and insufficient. From within our existing framework we will remain incapable of applying to our everyday practice the insights which neuroscience affords us.

The tradition of Body Psychotherapy

There is one therapeutic approach where the otherwise neglected and repressed body has been championed: the Body Psychotherapy tradition. Since the 1930s, Wilhelm Reich⁸ and his followers have developed models, concepts and techniques which attend to the body, emphasise its role in therapy and work with it. A sophisticated developmental theory and typology⁹ has been complemented by powerful techniques, based on radical assumptions about the body/mind, many of which are now being confirmed by neuroscience. Over the last eight decades, Body Psychotherapy has accumulated a set of perceptive, theoretical and practical tools which are inherently holistic and are more congruent with a 21st century conception of body, mind, brain and consciousness.

However, for all its precious ideas and techniques, as one splinter in a fragmented field Body Psychotherapy has paid a high price for developing its specialist expertise - like every other approach it has its wounds and gifts. It has its areas of undifferentiated perception, its habitual assumptions, partialities and rigidities. These shadow aspects have not passed unnoticed, and have led to criticisms and also prejudices against it. Other approaches have rightly held back from importing some of the more biased, one-sided and objectifying body-oriented attitudes and practices.

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Body Psychotherapy's shadow aspects and inherited wounds

Originally, Body Psychotherapy had to take a polarised position in the field, trying to reverse the cultural dominance of mind over body¹¹ . Body Psychotherapists were in the habit of seeing the mind as the problem and the body as the solution. Out of an underlying idealisation of the body, we tended to use the body as an avenue to break through the armour, to undercut the defences or to access primary impulses. Ironically, Body Psychotherapy, for all its championing of the body, had an inherent tendency to objectify the body. The more Body Psychotherapy was confused with and reduced to pure bodywork, the more it was seen to be treating the body rather than also relating to it, and from within it ¹² . As a consequence, not much attention was given to the transference, let alone the countertransference, prompting the prejudice that Body Psychotherapy boils down to a set of body-oriented, often provocative techniques. If people know of its existence at all, in the public imagination it appears as a mixture of crackpot orgone boxes and wild, primal expression of raw emotion.

The kernel of truth is that traditionally Body Psychotherapy was characterised both by an emphasis on catharsis on the one hand, and a tendency towards gratification on the other, leading to a lack of containment and boundaries, and dangers of regression and re-traumatisation.

Chiron Body Psychotherapy: a relational model of the body/mind both intra-psychically and intersubjectively

Whilst we appreciate traditional Body Psychotherapy for its incisive, holistic perception of the body/mind split in our culture, in our profession and primarily - in our clients¹³ , we no longer believe that we can bring about a healing of that split as desirable as that may be simply through application of theory and technique. Such a medical model attitude we now recognise as relationally oblivious to the effects of the therapeutic stance we are taking ¹⁴ .

At Chiron we are interested both in the split or the disconnection between mind and body and their potential integration and wholeness. We are not habitually biased for or against duality or unity of body and mind, but work with the tension between the two, attending first and foremost to what is.

Rather than idealising the body and treating it as if it had the answer, we now ask:

• How does the mind relate to the body ?

• How does the body relate to the mind ?

• What is the existing relationship between body and mind which constitutes the systemic-holistic context for the psychological problem?

• And what other (past and current) relationships does this resemble, repeat or re-enact?

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Body Psychotherapy can help integrate person-centred and psychodynamic perspectives

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Conclusion

Body Psychotherapy, having over the last 20 years worked through some of its own wounds as a tradition and its inherent set of habitual and rigid assumptions, can provide some valuable holistic pointers to the rest of the field which is struggling with (and against) an over-reliance on insight, language, reflection and mental understanding.

An integral-relational approach to Body Psychotherapy can offer practitioners from other orientations the most essential, useful and productive aspects of that approach without the traditional baggage. It can help counselling digest and apply the insights of modern neuroscience without succumbing to scientific objectification, thus maintaining the integrity of our discipline with its attention to human contact, subjective and intersubjective realities and the inner world of feeling and imagination.

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