Luciano Rispoli psicoterapeuta: Body-psychotherapy.

in Energy & Character, December 1991 (Ed. Inglese).

Luciano Rispoli: Founder and president of SIF (Italian Society of Functional Body Psychotherapy; member of the International Committee for BodyPsaychotherapy; President Italian National Association for body- l’svcflotherapy; President italian Society of Clinical Psychoiogy and Psychotherapy (athhiated to SIPs Italian Society ot Psychologists).

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Science and psychotherapy

Prigogines, a great scholar that he was, always claimed that a modem science should be truly holistic, a science that would not build itself up into little specialities, nor break itself up into details but should try to reassemble branches of knowledge into a whole. This kind of science attempts to create a bridge between the being and the becoming of nature, since it looks on the universe as evolving constantly and not as a static entity. But it also attempts to construct a bridge between the different aspects of nature that we come into contact with ( in particular human beings and their relationships) and the different was in which we attempt to interpret its functionìng. Recent studies of the mind and the brain have shown that the various parts of the brain and the neurons are less specialised than was originally supposed and are what Is more able to modify their various tasks fairly easily. Thus the brain itself presents, above and beyond the different functions that it Is assigned, a basically unitary nature. The Science P refers to is a science that accepts complexity without giving up the attempt to understand and explain it; a science that attempts to give a mathematical and thus rigorous form to the laws of chaos.Thus we are in a position of equilibrium, a very delicate but significant balance, between on the one hand overcoming an obtuse kind of determinism ( excessively reductive, linear cause and effect, only quantitive laws, banalising simplifications etc.) and on the other a purely chaotic concept of reality. seen as unrepeatable, impossible to study, understand or predict. I have quoted P because his concept of science IS one which fits our discipline or fìeld perfectly, if we look on psychotherapy in the broad sense rather than the narrow, not just as the curing of pathologies but above all as the possibility of reading, analysing and understanding the complex functioning of the human being and their relationship with the environment.

The origins of body-psychotherapy

It was in the 20’s that Wilhelm Reich proposed the first hypotheses as to the existence of deep and complex interconnections between psychic and somatic, as to laws of functional identity between the two aspects of the same reality, as to the need in psychotherapy to intervene also with the body. In fact the need for a study of the functioning of the psyche which would take into account body processes had already been initiated with Freud’s formulations. In Freud this aspect appeared, following the model of the science of that period as a “biologism in his drive theory. But the body could not just be relegated to the infancy of the individual; it was still present within the therapeutic relationship, in the processes of communication, even if one only attempted to take up only the verbal, symbolic or phantasmatic. The body exists in the silences, the tone of voice, movement and the position that the therapist assumes with respect to the patient inside the setting. One talks and acts with the body even if implicitly or unconsciously and in therapy both the body of the patient and the therapist are present. This explains why the importance of the body has really always been recognised in the history of clinical psychology, even though in a somewhat underground and non organic fashion. interest in the body has always been lively and has prompted numerous researchers to look into this vast and fascinating area. The history of therapies is therefore punctuated by authors who have moved in this direction. Within the psychoanalytic model it Is enough o mention Ferenczi’s active technique, Alexander’ s corrective emotional experience, Winnicott’ s concept of holding and Balint’s primary love, Racker and the concept of methodology and technique and on down through to Fairburn, Kohut and Stern with their formulations of the Self and the recent theses of haptics of This and Veldman. Other significant examples come from other clinical models: from behaviourism with ìts concept of modelling and tlooding br example, gestalt with its interest in the body is rcpresented and represents itself to others, from Schultz with his tcchniques of autogenous training and so on. l3ut it is stili Reich who founded the bases tòr a new bodymmd theorv, that of the direct approach, a deep and systematic approach to the body in therapy. 1HS concept of functional iden titv between psyche and soma opened up the great discovery that it is in the body that the history of our emotions and the development of our life is written from birth. Reich then was the most important of the researchers who laid the foundations of the theoretical area of bodypsvchotherapy, having shown through intuitions which were incredible for those times that i’t was necessary to integrate traditional therapeutic work with interventions on thebody aimed at modifying muscular and neurovegetative conditions which would otherwise have continued to retro act on the patient and bring him back to a state of lllness. Under the impact of certain of Reich’s ideas which were recuperated in Europe in the 60’s (after his final biophysical period in America) and of the advent of encounter groups which were spreading in California in the same period, the impact of Schutz’s ideas, a reevaiuation of oriental physical disciplines, experiences in dance and movement, of research in psychomotricity, the numerous techniques of bodv psychotherapv were born and multiplled. However sometimes ihese techniques carne to be used for their own sake, without a theor; sometimes they would go to the other extreme to that of verbai therapies and work prevalently 4f not exciusiveiy with the body. What Is true though is that this ferment of research and experimentation had set off an unstoppable movement which aside from anv understandable errors, brought about one of the theoreticai areas of clinicai psychology which is extremely rich in potential and activity.

The developrnent of bodypsychotherapy

Seventy years have passedsince the first foundations of this area of psychoiogy whìch is stili innovative, which has gone along paths which were not always easy, which has encountered ohstacles to its entry into officiai science and which has at times got iOSt in meanders and coilaterai branches of littie importance or i ncorrect scientific set. But despite these difficulties, in 70 years hod’ps’chotherapv has developed considerabiy, has ieft behind those rather mechanistic visions, partial and iimited visions, mvstical temptations, exaggeratedly experientiai attitudes, too intuitive ideas. And in this long ad somewhat tortuous path it has found its identitv, as a theoretical and technical area (though multiform) as a great model of hurnan functioning. Certainly bodjpsvchotherapy has suffered for its vocation to give great weight to feeling and experiencing rather than to conceptuaiising and the cognitive. In all these years not enough has been written and sometimes only to describe clinical cases, without reflecting without citing other authors wìthout accepting comparisons or openìng up to reciprocal criticism. What was given great space was the dimension of the experimental, the encounter with the new but this does not mean that theoretical development did not take piace that the path taken, stili complex and not always scientifically -clear, did not produce a growth in knowledge, techniques and applications to various fields, with a resuiting growth in the potential that the new mind-body concept hypothesized by the early authors alreadv carried within it. But what is it that really charcterises this great clinical area, this model of generai psychology, developmentai psychoiogv, of psvc hopathoiogy and psvchotherapy? The theoretical concepts of bodypsychotherapy. Bodvpsvchotherapv distinguishes itself not so much for the direct use of the body in therapy but fundamentallvand essen tiallv for a differen t inheren t theorv of mind-bodv functioning: no ionger pvramidal, with the mmd controlling evervthing from above, but of a circular nature in which ali the various psychocorpoeral levels contribute in equal fashion to the cornplex organisation of the organìsm. Rationality, memories, the symbolìc world, and then postures and movements, the world of the emotions, and finaliy the internal physiological systems are so many psychocorporeal functions which, integrated and deeplv connected in the baby can become disconnected from each other and become iimited or scleroticised. rage can be manifested only in a clenched jaw or fists: a face can express sadness without the person being aware of 11; a disappointment can become a contraction in the stomach; sweating palms and tacchycardia can reveal a fear that is not perceived; thoughts can keep on coming back to the same point: kntasies can be obsessively fearful; tense muscles produce a perennial state of alarm and so on. Bodvpsvchotherapv (and in particular functional bodvpsychotherapy) has systematicallv studied the relationships between all these levels, the laws which govern them, the way in which oid experiences have become crystalised in each one of them and continue to interfere with daily life. In therapy the aim is to get such deeply buried functioning to re emerge, to be remobllised and to reconstruct the original connections between the various levels of the psychocorporeal unit thus recreating harmony and equilibrium between the various aspects of the person and restoring the capacity to work in the world of relationships in adequate fashion with respect to the environment and with a fuli capacìty for contact. From this it is clear then that body psychotherapy is not defined in that it intervenes directiy on the body; just as family therapy is not defined just because it works with the famiiy and group analvsis because it works with groups. Working with families has led to an awareness of processes and functions that concern the individuai as part of a ‘family systemt, with precise laws ol reiationships. in the same way with ‘groupality’ (network, matrix, transpersonai) what were revealed were internal group aspects of the individuai, that is a wav of reading and interpreting human functioning through a particuiar viewpoint. in the same way having used the body directly in therapv (touching, inducing movement, modifying postures and ways of moving, massaging in particuiar ways) cannot just be seen as the addition of a new technique but constitutes a factor of radical transformation in the models of psychotherapy. When peopie began to work with the body in psychotherapv over seventy years ago a whoie series of phenomena were brought to light, of relations, processes which had not been placed up ti!! then which, iike in the case of family and groupanalvsis have pro fo undlv modified the epistemoiog icai framework that we stared with, the initiai frame and naturaily the set of techniques. A theory of personaiity which was abie to explain such phenomena had to be different as the hypotheses about the phases in the development of the chiid had to be changed, from the prenatai period onwards. And llnaiiy changes had to be made in the retlections about how pathoiogy comes about and a!terations in the psychophysicai functioning of the person, from the simpiest disturbances to the more serious pathologies. The centra! nucieus of the probiem is that when one uses physical contact with a patient the whoie theoreticai framework has to change. When the technique of the ‘famiiy sculpturet is used in famiiy therapy it cannot be denied that acting on the body produces movements and events which are specific in certain wavs, which is not the same as imagining such actions or symboiising them. Something happens which cannot be recounted in words and – here we trans!ate what has happened – something which cannot be expiained with the paradigms of that theoreticai mode! with those constructs and their usuai words. From another point of view we must ask whv have some psvchoanalvsts started to introduce the use of bodv techniques claiming that breathing techniques are necessarv with psychosomatic patients? When psychoanalvsts, to give another example, introduce direct contact with the patient’s body (in some cases declaring it ofllcially as in the case of relaxation or of haptonomie of Veldman and This) what has come into the theoretical model? In order to understand this we have to understand whv they do it. If indeed psvchosomatic body processes are as they claim at a theoretical leve! – preverbal and presymbolic, there is no point in going back to such archaic experiences since they could never get to what is considered to be the fulcrum of transformation in psychoanalysis, the possibility of elaboration and symbolisation. let us not forget that acting in psychoanalysis is considered to be ‘acting outTT or “discharging directly and is something which opposes re-elaboration. If on the other hand one admits a direct influence of body levels and related different states of consciousness on adult symbolic life then one has already left the framework of psvchoanalysis and starts to get into the formulations which helong to body psvchotherapv. What happens when the body is moved or touched that makes psychoanalysts transgress the abstinence principle? a principle which is certainly not of a moral order but a purely theoretical one and as such constìtutes one of the basic constructs of psvchoanalvsis. When the reply given is that this is the only way to get emotions, experiences and sensations to emerge that would otherwise never have come to light, that would then never have been perceived, thought or even if in inadequate fashion communicated, or even that this is a way of accelerating or intensiliying abreactive dynamic and elaborative processes then once again the whole psychoanalytic set up has been radically changed. We have already moved into another theoretical sphere, other hvpotheses which are taking the very path that body psvchotherapy took over seventy years ago. In order to be able to explain how the body can get far back experiences to reemerge directly one must begin to hypothesize that the elaborative processes do not have control over our functioning and that they are not set above a biologica! element, a proto- mental element both original and deprived of consciousness. One has to admit that there can be an autonomi ot body tunctions when these are disconnected from an original state of integration and above all that these are not only influenced by but that they in their turn influence , on equal terms, our thoughts and mental schemes and representations. Then we discover that the symbolic cannot always manage to transform the body and not because the latter belongs to a pre-symbolic era. indeed even if one were to posit as an absurd hypothesis it would be of no use, as we have said, to get it to re emerge because being pre-symbolic it would not be usable in the psychoanalytic process. Thus we are obliged to realise that the body does allow processes of symbolisation to come about which otherwise would not be opened up. We have to posit some sort of “body-memory’T and the existence of a stratification of emotions in various areas of the body. Anyway if one can get preverbal (but not only preverbal)experiences to reemerge by moving the body this means that primary processes are not so far removed from secondary processes, that psychocorporeal processes evolve and do not have such an abrupt and total discontinuity. There are numerous hypotheses about the infantile psychic life which go in this direction from Stern’s “experience envelopes” to Bowlby’s schemata of attachment, from Winnicott’s psychosoma to the resonance identification of Weiss and Sandier. Once one has got this far in one’s reasoning then we must understand why in bodypsychotherapy unusual sensations and perceptions emerge: such as tremors, tingling, streaming etc. WHY is it that certain areas get cold or hot, are perceived as heavy or light, big or swollen or smail. Such psychophysical changes are explained in bodypsvchotherapy as an emerging of extremely intense but buried experiences, an emerging of “unconsciousT’ body material, of experiences, emotions, memories and physical sensations that have been lost: sounds, touch, sight, smeli or whatever. In order to work directly with the body then it Is indispensable to know how the physiological apparatus is connected with postures and the muscular, where the neurone cortico-muscular paths lead and cortico-visceral, both ascending and descending, how the neurovegetative system acts on the rest of the organism; how it intiuences breathing, and more precisely particular tvpes of breathing,; what effect altered muscle tone has on the level of emotions, the symbolic, memories and elaboration. It Is indispensable to know what physical contact can produce in the patient and how and with what consequences different ways of touching, moving, inducing movement and breathing. And all this so as not to proceed blindlv at random and so as not lo run the risk of making therapy iatrogenic.In other words if the buried experiences lying hidden within the various areas of the self have a signiflcant influence on present conditions and ìf as a consequence both gratification and frustration became possible then it is absolutely indispensable for regression to such experiences to take on a positive connotation. It is indispensable then that such experiences begone through on all levels of the self, made gratitying and nurturing transforming the old traces and outcomes where they have a negative connotation in order to avoid repeating the same set of negative events that the patients have already been through in the development: indifference, incomprehension, detachment, hostility, mistrust or coldness towards them.
Now such an articulated complex of hypotheses, centred on a fundamental circularity of boy-psyche connections cannot be sucked into psychoanalysis and its theoretical framework and epistemology nor by other approaches as is evident. Nor can one justify the introduction of direct work on the body in these other therapeutic approaches simply because there is the assumption the “if I only touch a bit then I don’t necessarily have to change my theoretical framework or outlook”, in fact “only a bit” can often be far more upsetting than a lot, and therefore if ìt is lacking in theoretical criteria far more dangerous. The whole problematic has already been dealt with in the lc)ng journey of bodypsychotherapy up tili now. it would be absurd to pretend that such competence does not exist and to begin again from the beginning and discover the wheel all over again, following the same route, beginning with hypnosis, in order to discover the existence of the unconscious and the phenomena of transference. What is more no-one today would dream of ‘discovering’ and considering them to be one’s own personal achievement, the laws of behaviourism, cognitive processes, systemic relationships, group matrices. And what we have outlined for psychoanalysis holds for these other theoretical areas.

The specificity of bodypsychotherapy

The heritage of bodpsvchotherapv should not therefore be dispersed but should rather be valued and developed. 11 is one thìng to start compare with other theoretical areas of psyc hotherapy (psychoanalysis, cognitivism, i ung hian therapy and so on) a comparison whìch Is necessary in order to be able to progress in this discipline, a comparison that started some time ago and which bit by bit will help to integrate knowledge, but it is yet another thing to allow bodypsychotherapy to dissolve and to consider that it belongs in part to psvchoanalysis, in part to gestalt in part to systemìc therapy. Apart from the case of gestalt whìch could prohably be legitimatelv considered in the other direction, that Is that gestalt belongs to the bodypsychotherapy area, the specificity of bodypsychotherapy, its theoretical principles which are origina] and which belong to it from the concept of body memory to the unitary nature of psyche and soma, the circular relationship on an equal basis between the corporeal and the mental and that ot the polarity of the various psychocorporeal functions, from the denial of the death instinct to the importance of the environment and holding in the development of the child: from the original integration of the self and the processes which make it up to the stratification of emotions in the various parts of the body; from the importance of movement and postures to that of the internal systems such as the respiratory and neurovegetative. The various theoretical areas carne about from having taken into consideration the person and his/her relationships according to different points of view, discovering phenomena which were visible only from that viewpoint and elaborating theoretical models to account for them. rphat Is why the models are different and each one brings with it basic germs validity, in the same wav as they also tend to drag with them formuiations which recent research has proved no longer to be valid. Bodypsychotherapy Is one of these models with its own theory as weil s its own techniques. Not only that: bodypsychotherapy is the theory which is most able to take into account and deal with the problem of complexityin human functioning since it 15 used by its very nature to considering several levels at once. As long as we start to get over those concepts which are too vague, such as the dichotomy between mmd and body, and we begin to talk of psychocorporeal processes, getting down to the detaiis of all the functions which go to make up the self: from memories to rationality, from the symbolic to fantasies, from postures to movements, from emotìons to the shape of the body, from the neurovegetative system to perceptions. it is only in this way that we wiil be able to reach unitariety, complexity and at the same time concreteness and plurality of levels on which to operate, the concept of holism rhich Is not vague but extremely rich and detailed. This Is why hodvpsychotherapy more than any other approach has the important task of making permeable the frontiers of the various approaches in order to construct together a model which is broader and more complex but without giving up its own contributions, its own theoretical formulations elaborated over 70 years of experience and research; with giving up its self but rather claiming with head held high that which it has contributed and has stili to contribute to psychotherapy and to science in generai.