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In this Update:

1. Coming up soon: another CPD Weekend with Nick Totton and Michael: "What Can Therapy Hope to Achieve?" - Oxford: Oct. 9th & 10th 2010

2. Dates of CPD Workshops and Events for 2010/2011

3. Have you seen "In Treatment" ? - TV series on psychotherapy by HBO, starring Gabriel Byrne

4. New CPD Training website to be launched soon

New project INTEGRA CPD - a programme of ground-breaking courses and events

5. Autumn Edition of UKCP Journal 'The Psychotherapist' on the body in psychotherapy

"The Return of the Repressed Body – Not a Smooth Affair" - article by Michael

Dear Colleagues,

here's another update on events and activities that I am planning for next year.

This mailout now has many more subscribers, partly through the recent CPD events I have been running, and soon I will be getting more organised about publicising and marketing future events (see info below about the new CPD Training website).

But in the meantime, we have left it rather late with letting people know about the CPD weekend Nick Totton and I will be running in Oxford in October (9th and 10th) - if you could help us spread the word about that event, I'd be grateful.

It is designed to address a fundamental question which is hovering in the background of every consulting room as a perennial issue: what degree of impact and what kind of transformational effects does therapy have and can it have ?

It's entitled: "What Can Therapy Hope to Achieve?"

Are we over-marketing ourselves as therapists and making false or exaggerated promises, or are we setting our sights too low in terms of therapy's impact and potential? Are we claiming more than we can deliver, or are we too modest and colluding with the denial and undervaluing of psychological process in our culture?

And what about dealing with the inevitable disappointments that would have to be part of the experience, especially when the stakes are high, and the process does not work the way clients imagine or demand it?

Both as clients and as therapists, we cannot escape these questions, and in this weekend we will try to address them head-on, experientially and philosophically.

This may also be an appropriate moment to mention that there are some people in Manchester who have been trying to arrange small group supervision and/or occasional CPD events, but to make the travel up North from Oxford feasible in terms of time and money, we need a few more people to join in ....

Lastly, before this update becomes over-full, do pencil in September 19th to 26th 2012 (!) for an exciting international conference (which is already in preparation). It is being organised by the Chiron Association for Body Psychotherapy as part of and on behalf of the European Association for Body Psychotherapy.

Have a good summer ...

Michael

1."What Can Therapy Hope to Achieve?"

another CPD Weekend with Nick Totton and Michael Soth

Following on from the well-attended weekend in May 2009, we are organising another CPD weekend, of interest to practitioners from across the diverse approaches. It's scheduled for October 9th and 10th 2010 in Oxford. Here is our idea for it:

Since its beginnings, therapy has argued with itself over its proper goals and aspirations.
Are we seeking to bring our clients and ourselves to a state of of complete psychological health, in whatever terms the various approaches formulate this, e.g. genital character, enlightenment, primally clear, revolutionary consciousness, authentic selfhood, integrated bodymindspirit, all our issues worked through, ‘analysed right down to the bedrock’?
Or should our ambitions be more humble, seeking only to expose the basic wound, to come to terms with human grief and limitation, embrace ambivalence, reach the depressive position, accept existential pain?
There are moments in our experience as both therapists and clients which encourage us into each of these belief systems. When we identify with something more like the first option, the second seems paltry and compromised; when we identify with the second, the first seems grandiose and narcissistic.

Is there a way to reconcile the two? Or a middle way between them? Or do we need to hold one in each hand? Or is it perhaps a matter of what suits our individual personality?
This workshop, conducted by two leading body psychotherapists, will explore all of these problems both experientially and theoretically. We will be entering into it without a prepared solution of our own, and we invite you to do the same.
The workshop is open to practitioners from all therapeutic schools and orientations, interested in exploring these fundamental aspects of our work.
We invite you to bring yourself, as a person and as a practitioner, with your passions and dilemmas, your wounds and shadows, your questions and beliefs, to contribute to the explorations which this weekend group experience seeks to open out.

2. Dates of CPD Workshops for 2010/2011

Here is a preliminary list of dates for CPD events, but some more are in the pipeline. You can find updated details of times and venues on my (otherwise ancient) website, in the CPD section.

Reading Nov. 9: Learning from Impasses, Enactments and Breakdowns in the Working Alliance

London Nov. 20/21: Working with Illness

London Feb. 5/6: Working with Difficult Dynamics in the Therapeutic Relationship

Bristol May 16: How to Work when Therapy isn't Working? - Embodied Pathways Towards Resolving Impasses, Breakdowns and Enactments

Kendal May 21/22: Northern College for Body Psychotherapy - Weekend CPD workshop

London June 25/26: PET CPD Weekend: Working with Subpersonalities in and through the Body (tbc)

Also being negotiated are other talks and workshops, in Bristol (on the recent history of Body Psychotherapy) and for CONFER in London on the topic of 'Enactment as the crucial relational paradox at the heart of the helping relationship'.

3. Have you seen "In Treatment" ? - TV series by HBO, starring Gabriel Byrne

If you haven't come across it, I can thoroughly recommend the TV series 'In Treatment' which demonstrates both the glories and the fallacies of a modern relational approach to therapy, and brings the messy reality of the process and the therapeutic relationship alive in a way that I have not seen on screen before. Although it is scripted as entertainment, it feels incredibly real, and the characters are believable and engaging, partly due to the exquisite acting.

In fact, it seems so real, with all the pitfalls and dilemmas of therapy unflinchingly brought to a head, that it may work well as teaching material, and I have an idea to record some YouTube videos with commentaries and specific questions for reflection on each episode.

I would welcome comments and feedback from everybody who has seen the series, especially those of you who have watched all 78 episodes. If you're not sure how to get hold of the series on DVDs, do get in touch.

From a review: "An emotional and provocative series, 'In Treatment' brings dynamic focus to a staple of modern society - the psychotherapy session. Adapted from a popular Israeli series, the show follows psychoanalyst Paul Weston (Gabriel Byrne, who won a Golden Globe® for his role) through his week, capturing sessions with his patients."

4. New CPD Training website to be launched soon

Because of family commitments, my new project since the winter, called INTEGRA CPD, is a bit delayed. It is a project that will bring together under one umbrella and in one place a programme of courses and events that are inspired by an integrative, integral, embodied and relational perspective.

To begin with, it will continue to include existing CPD events that my wife Morit and I have been involved with for many years, i.e. courses that we have been invited to run for other therapeutic organisations, groups and training institutes.

Our vision now goes beyond this. Our hope is to eventually develop a comprehensive integral-relational CPD programme, in collaboration with practitioners like yourself and in response to your needs and feedback.

Apart from information about all scheduled and planned CPD events, the website will include a blog, papers, articles and hand-outs, as well as eventually some training videos.

5. The Return of the Repressed Body – Not a Smooth Affair

article for UKCP Journal 'The Psychotherapist' by Michael Soth

Kathrin Stauffer, chair of the the Chiron Association for Body Psychotherapist, has been editing an upcoming edition of 'The Psychotherapist', and here is Michael's unshortened contribution:

As valuable, valid and indeed urgent the impulse is becoming to (re-)include the body into the predominantly verbal practice of psychotherapy, there is increasing evidence that in many instances this project is backfiring. Frequently, I am hearing stories about breakdowns in therapeutic relationships in the aftermath of attempts by the therapist to ‘work with the body’ (Soth 2002).
The return of the excluded and repressed can never be a smooth affair, and that seems to be true also for the body in psychotherapy - how can we seriously imagine that bringing the body back after 100 years of disembodied ‘talking therapies’ is just a question of a few new techniques?
Those modern approaches who would simply have us graft the body back onto established therapeutic practice tend to overlook the long-standing and ingrained conflicts that resulted in it being excluded and repressed in the first place (Soth 2006a).
A whole paradigm shift is involved that – when neuroscience encountered the same questions in the 1990’s - shook the discipline right down to its foundations and basic principles.

What can we learn from neuroscience ?

Over the last 10 years, it has become fashionable to try and back up the culturally shaky foundations of our therapeutic practice with the now scientifically credible insights of modern neuroscience.
The three sibling disciplines of neuroscience, genetics and psychoanalysis were all born within the zeitgeist of the late 19th century. Whereas our practice is still deeply embedded in what I call the ‘birth trauma’ of our profession (Soth 2006b), neuroscience and genetics have at least partly managed to extricate themselves from the positivist and dualistic assumptions of their origins.
Consequently, there is a lot we can learn from how neuroscience has re-envisioned the body-mind relationship.

Body and mind as parallel and mutually correlated processes?

Take, for example, this quote from Damasio (2004, p. 217): “What is Spinoza’s insight then? That mind and body are parallel and mutually correlated processes, mimicking each other at every crossroad, as two faces of the same thing.”

That is a long way away from how counselling and therapy are being practiced. To this day, most of our psychotherapeutic theories and most of our techniques give primacy to the reflective mind and verbal interaction. As a profession, we do not work as if spontaneous somatic and feeling processes are mutually constitutive with thoughts, beliefs, insights and decisions - not as clients, let alone as therapists. We may pay lipservice to Damasio’s abstract, philosophical idea, but when it comes to the nitty-gritty of clients’ painful patterns most therapeutic practice relies on finding solutions, meaning and identity in symbolisation, words and conscious choice over and against supposedly pathological impulses, urges and internal states.
Addiction is fought by insight and will. Panic is reflected upon in terms of its traumatic sources. Compulsion is interpreted for its unconscious drivers. Negative self-images are corrected by rational thought. Uncomfortable feeling states are counteracted or overridden by conscious strategies. Self-destructive patterns are overcome by healthy new choices.
Across the modalities and plethora of therapeutic approaches, whatever the psychological problem, the answer is sought in mental understanding, left-brain strategies and verbally communicated content. The implicit assumption: the avenue towards psychological health leads via the consciousness of the reflective mind, and pathology resides in the irrationality of spontaneous processes (physical and emotional impulses).
In most therapeutic practice, the relationship of mind and body is still a one-way street. Each approach formulates this bias in its own language, but the principle remains ‘where Id was, there Ego shall be’, with the mind telling the body who to be, how to behave and how to override the ‘symptom’ and perceived dysfunction. The paradigm remains – as it was taken for granted by Freud - mind-over-body dualism. From within that paradigm, it’s not surprising that we badly need neuroscience to help us into the 21st century.

Therapy as right-brain-to-right-brain interaction

Take Schore (1999, 2003, 2009): “right-brain to right-brain emotional processes are essential to development, psychopathology, and psychotherapy (Schore, 1994) and “the system that underlies psychotherapeutic change is in the nonverbal right as opposed to the verbal left hemisphere. … An intersubjective field is more than just an interaction of two minds, but also of two bodies.”
If we took seriously what Schore is saying, we would need to consider 90% of counselling and psychotherapy training – focussing on our conscious, reflective, intentional left-brain capacities via theory and technique – as ineffective and beside the point.
The spontaneous, pre-reflexive, non-verbal dance between client and therapist – communicated via the bodies and mediated via the right brains – is and has been going on all along, right under our unsuspecting noses, sometimes supporting, sometimes scuppering our left-brain efforts and intentions. It’s just that for a century we have systematically trained ourselves to override the significance of that dance and ignore the overwhelming multitude of non-verbal messages as irrelevant data. In the context of neuroscience’s abstract insights (Schore 2009), it seems profoundly last millennium to continue with this, and so the urgent question arises: how – in actual moment-to-moment psychological practice – do we include the bodies and awareness of the bodies ? How do we do justice to the quickfire reciprocity of spontaneous and reflective processes – sensations, feelings, images, thoughts - and the parallel process feedback loops ricocheting throughout the complex body-mind system? How are psychological conflicts embodied, and how does somatic experience structure and shape mental processes?

Common pitfalls in attempts to re-include the body

Unfortunately, alongside much-needed interest, research and contemplation, these questions have also quickly generated a host of new techniques and simplistic answers which short-circuit the subjective complexity and conflictedness of the body-mind relationship.

Importing neuroscience wholesale

One tendency, for example, in recognition of neuroscience’s groundbreaking input, is to import its objectifying, scientific paradigm wholesale – we then easily end up confusing our clients by incongruously oscillating between contradictory stances of therapist and neuroscientific expert, between relating and instructing, typically switching into ‘medical model’ interventions in moments of hyper-arousal. Often, clients will unconsciously interpret this as the therapist’s anxiety, abandoning the pain by taking refuge in practical strategies and manoeuvres.

‘Using’ the body

Another tendency is to use the body as an alternative avenue or therapeutic vehicle in moments of stuckness or impasse, e.g. to circumvent an otherwise insurmountable resistance, as a gratifying short-cut towards reparative nurturing, as a route for accessing primal catharsis, or for somatic psycho-education.
But in all these procedures, what part of me is using what other part of me ? Is my body an object ? Or is my body me as the subject ? Are my body and mind one or two ?
You see, both sides are partly true, and partly untrue; partly healthy, partly unhealthy; partly wise, partly unwise.
"Our body and mind are not two, and not one. If you think that your body and mind are two, that is wrong. If you think that your body and mind are one, that is also wrong. Our body and mind are both two and one." Shunryu Suzuki: 'Zen Mind, Beginner's Mind'
I can ride roughshod over these apparently abstract subtleties, but using the body – for whatever purposes, including therapeutic ones – is liable to exacerbate the ways in which clients use their already objectified bodies, out of a fundamental condition of disembodiment (Soth 2006a).
In this condition, an identity - presumed to be originating in the mind – then decides to use the body for its purposes much in the same way that a man might use a horse.
Ken Wilber puts it neatly: “I beat it or praise it, I feed it and clean and nurse it when necessary. I urge it on without consulting it and hold it back against its will. When my body-horse is well-behaved I generally ignore it, but when it gets unruly - which is all too often - I pull out the whip to beat it back into reasonable submission.”
There are many disciplines, including bodywork and other complementary and holistic therapies which helpfully educate the body in terms of posture, breath or movement. Nothing at all wrong with them, and I practice a good few myself. But whilst their theories recognises the interplay between body and psyche, they are not necessarily capable nor designed to address disembodiment: they do not work psychologically from the client’s experience of their body as the potential ground for embodied and relational subjectivity, what Winnicott calls ‘indwelling of the psyche in the soma’.

Mindfulness

Another example is the inclusion of the body in mindfulness practices for therapeutic purposes. Whilst undoubtedly based on precious principles, too often his ends up with therapists instructing a disembodied and defensive ego in the kind of mindfulness which – in the territory of the wounding – the ego is precisely incapable of. Mindfulness – starting from the Buddha’s first noble truth of suffering - requires an embracing of the wounding. However, we could argue that – at least unconsciously - clients come to therapy because their ego is chronically and systematically at war with the wounding.

What kind of relationship facilitates ‘bodymind integration’?

Both in infant development and in therapy, the ‘indwelling of the psyche in the soma’ or ‘bodymind integration’ is a function of intersubjective, emotional relating. This requires a delicate dance between mental and physical awareness, between body and mind as two and as one, between merging and mirroring versus recognition of difference and separateness, between the body as object and the ‘felt sense’ of emergent subjectivity.
Any approach which takes a fixed therapeutic stance, exclusively identifying with one or the other side of these tensions and failing to bridge or stretch across these contradictions and paradoxes, cannot hope to address the wounds and bodymind incongruities at the root of disembodiment.
However helpful they are in themselves, physical procedures, exercises and strategies imply mental impositions onto the body. In the actual doing of the exercise, the implicit mind-over-body duality might drop away or be transcended, but generally speaking using the body rarely leads to an integrated bodymind sense of self.
The development or recovery of an organismic or embodied self depends on room for spontaneity as well as mental impositions. Most importantly, it needs a space and a relationship in which the inherent pre-existing conflicts can be experienced, felt and addressed.

A prolegomenon to including the body in psychotherapy

As you can gather from the above examples, in my view we are not quite ready to re-include the body in psychotherapy. Some paradigm-shifting recognitions need to be embraced first.

The client’s existing matrix of body-mind relationships

We cannot work with the body and embodiment unless we take as our starting point the client’s existing body-mind relationship with its characterological patterns of conflict, disembodiment and dissociation. Without recognising the psychological significance of these habitual body-mind patterns (the tensions, ‘ripeness’ and robustness of the system, its tendencies for defensiveness, hyper-arousal or splitting off), making body-oriented interventions is like giving driving instructions without knowing whether we’re driving on a motorway or on hairpin bends in the mountains. It is the psycho-somatic landscape of the client’s identity, their incarnated life story as present in front of us here and now, which constitutes the context for engaging with the current bodymind state and its charge and relational implications.
Such an understanding would not be difficult to establish throughout the profession, as it can be derived, with some adjustments, from existing theories in body psychotherapy, neuro-psychoanalysis, process-oriented psychology and others (Johnson 1994).

Working with the body – a question of techniques?

As psychotherapy has taken decades to recognise, it’s not the technique that in and of itself does the work. In my opinion, that is a precious insight. However, when it comes to including the body – which most of us are culturally conditioned to treat as an object – we think we can jettison that precious recognition, and revert to body-based techniques. But it’s just as true in relation to the bodymind as it is in relation to the psyche or the client’s subjectivity, that ”it is the relationship that matters.”
Psychotherapy recognises that when it comes to doing justice to the person in front of us, all techniques, general external guidelines and standards become secondary. It does not matter what is true, what is healthy, what is a good idea in principle. What matters is how it is received by the client’s idiosyncratic being; how our input and response are refracted through the lens of their particular woundedness; how general truths operate within their individual psychology. It does not matter so much what I do, as the therapist. What matters is how it arrives, inside, in the client.

The bodymind sense of the working alliance

To deepen our sense of how it arrives, how the therapist’s contribution is received, processed and apprehended, to monitor the state of the relationship beyond the ego-ego left-brain-left-brain alliance, our perception of the bodies – the client’s and the therapist’s – is essential. The non-verbal and pre-verbal working alliance is a bodymind process which for most therapists is largely subliminal and unconscious. However, this is not simply a human given - it is a culturally constructed function of the profession’s traditional disembodiment. A therapist’s own lack of embodiment within the therapeutic position far outweighs in its effect any positive benefits which derive from the use of body-oriented therapeutic techniques.
Therefore, for the purposes of psychotherapy (rather than bodywork, movement and other bodymind practices), all behavioural instructions which impose potentially alienating routines on the client’s body are secondary to what emerges from the ‘felt sense’ and the subjective somatic experience in the relational engagement.
From a psychodynamic perspective, we might want to talk about this in terms of first establishing a bodymind sense and understanding of the transference-countertransference dynamic as a bodymind process, before we start using body-oriented techniques.
The more we are attuned to the client’s and our own non-verbal, spontaneous reactions and the corresponding ebbs and tides of the working alliance, the more it becomes apparent that there is no therapeutic approach or technique which is immune against feeding into counter-therapeutic dynamics and exacerbating the pre-established psychological conflicts in the client’s bodymind system. It is in providing avenues into recognising the phenomenon of enactment as central to the therapeutic relationship that a bodymind perspective can make its greatest contribution to the field (Soth 2008a).

Learning from 80 years of body psychotherapy

There is one branch of the psychotherapeutic field which has been trying to include the body for the last 80 years, and that is the approach of Body Psychotherapy, going back to Wilhelm Reich’s work in the 1930’s. At the Chiron Centre in London we have been struggling with the profound potential as well as the pitfalls and fallacies of that tradition for the last three decades.
Having been part this coming-of-age process, I have attempted elsewhere (Soth 2008b) to describe recent developments by distinguishing four phases. However, most readily available published material on body psychotherapy belongs to the first two phases, before the integration of other approaches and what I call the ‘relational turn’.
To therapist who are keen to include the body in their practice, I suggest to not simply refer back to the days when body psychotherapy was a young and idealistic discipline, but avail themselves of the often painful and difficult, but ultimately rewarding learning that has occurred in body psychotherapy in the last 20 years (Soth 2002, 2005, 2007, Totton 1998).

Michael Soth is an integral-relational Body Psychotherapist, trainer and supervisor (UKCP), Training Director at the Chiron Centre for Body Psychotherapy, with more than 20 years' experience of practising and teaching from an integrative perspective. He has written numerous articles and is a frequent presenter at conferences. Extracts from his published writing, summaries of presentations as well as the references for this article are available at www.soth.co.uk.

References

Damasio, A.R. (2004) Looking for Spinoza

Johnson, S. (1994) Character Styles. New York: W.W. Norton.

Schore, A.N. (2009) Right-Brain Affect Regulation: An Essential Mechanism of Development, Trauma, Dissociation, and Psychotherapy. In: D. Fosha, M. Solomon, & D. Siegel (Eds.), The healing power of emotion: Integrating relationships, body and mind. A dialogue among scientists and clinicians (pp. 112-144). New York: WW Norton.

Soth, M. (2002) What is 'working with the body' ? - A response to Maggie Turp’s paper from a Body Psychotherapy perspective, The European Journal of Psychotherapy, Counselling and Health, Volume 5 (No2), p. 121-133
Soth, M. (2005) Body Psychotherapy today - an integral-relational approach, Therapy Today, November 2005, Vol 16 No 9
Soth, M. (2006a) What therapeutic hope for a subjective mind in an objectified body? In: Journal for Body, Movement and Dance in Psychotherapy Volumes 1 and 2 (June & September 2006)
Soth, M. (2006b) How ‘the wound’ enters the room and the relationship, Therapy Today, December 2006
Soth, M. (2007) No ‘Relating Cure’ without Embodiment, Presentation to BACP Conference 2006, unpublished manuscript
Soth, M. (2008a) Enactment as a central principle of relational therapy, Presentation to BACP Conference 2008, unpublished manuscript
Soth, M. (2008b) From humanistic holism via the ‘integrative project’ towards integral-relational Body Psychotherapy. In: Hartley, L. (2008) Contemporary Body Psychotherapy - The Chiron Approach. Routledge