Psicoterapia Funzionale: Functional Body-Psychotherapy.

2nd European Congress of Body-Psychotherapy, Seefeld, 1989.

One of the first models to take into account the links between the psychic level and the somatic level in the therapeutic process, was that proposed by Wilhelm Reich, and known as character-analytic vegetotherapy. It was on his first intuitions and early theoretical formulations that a line of research was founded and has since been developed, that of the psycho-corporeal field.

       So what made up the essential nucleus of Reich’s innovative thinking?

The child has an out-going urge towards the world, integrated and unitary in origin and it is only when on coming into conflict with the world that this unit is split. The way in which the somatic and the psychic interact throughout the developmental process is made up of a well-defined mechanism, character and muscular structure. From this basic discovery it has become possible to go deeper into the field of psychosomatic integration, going beyond Reich’s early hypotheses and using the data which has been produced by various disciplines in the last few years. As we have already said the model which has been elaborated in the field of Vegetotherapy is notably more complex and articulated. This allows one to clarify, through the hypothesis of the corporeal-Self, how one in fact is presented not with a bi-polar structure but with a multilevel one and why acting merely on one of these is not effective.                  

The structure of that which we call “corporeal-Self” or “Functional-Self” present as an original nucleus in the newborn, can be thought of as made up of concurrent multiple functional Processes, from the apparatus of physiological functioning to the imaginative potential; from physical forms and structures to the level of emotions; from movement and posture to cognitive and symbolic elaboration. We may then arrive at a configuration of a basic unit which develops in various directions, which is, at the beginning, integrated, and which we call the “corporeal-Self” or “functional-Self”.

The expansion and general activity of the corporeal-Self are made up of processes and functions which proceed in all directions and which we can group into four main areas (fig. 1).

The first area is that of the specifically somatic structure: comprising the forms, body and configurations which the muscles assume, which together determine postures and demeanour.

The second area comprises the physiological apparatus  and systems (respiratory, neurovegetative, circolatory, etc.) internal functions and activity down to the cellular micro-level (from the visceral peristalsis to the chemical processes of metabolism).

A place is assigned in the third area to the affective and emotional life both because of the importance of the experience and feelings of the individual and because this area can develop in pathological fashion without maintaining complete connection with the others.

The last of these areas, to remain with this “quadrafunctional” model, deals with the modality of structuration of thought, the logico-cognitive, the fantasmatic and imaginative, the representation of the world through  symbols.

  1. is an imposing man, who has always based himself on strength, both physical and muscular, more apparent and displayed than acted upon, encouraged by having had to take on the conflicts with the outside world at an early age from the time when his parents decided to send him away to school. He thus learned early on to set up relations with others exclusively through being hard and through competition. Because of a resultant swelling up and stiffening he is hardly in contact with his own feelings and emotions, especially the softer, subtler ones.

Beyond the symptoms presented by the patient, it is possible to use the multifunctional model of the corporeal-Self for a more accurate diagnosis, to analyze how in a person’s history the original structure has been modified  (fig. 2). From the diagram it is obvious that G. has been forced to retract his emotional aspect (the small dimensions of the circle) and to rigidity and limit it to few and repeated feelings that he can allow himself. The somatic level is hypertrophic particularly with regard to the morphological subsystem. G. is large  and hyper muscular; the thorax hyperexpanded; the back broad and hardened; the shoulders large, hardened and raised. The postural level is  in this case represented by a smaller circle since the positions that he can take up normally are few and in this case repetitive. For example G. is unable to rotate the pelvis backwards and forwards. He also presents a particularly blocked neck with regard to rotatory movement. The “normal” circle represents the physiological level, and indicates an absence of any mayor functional or vegetative problems but it is still isolated from the other levels.   Finally the cognitive level, which is not extremely developed virtually coincides with the rationalising and controlling function, while the imaginative, ideational and symbolic are extremely limited.

All this, apart from the deep splits between the various functional levels and ever within one level, shows in a precise fashion how the false-Self developed and thickened in correspondence with the corporeal aspect, to the detriment of the original Self which, as in the diagram, is crushed and eroded with respect to a possible “healthy” configuration.

Throughout the first phase of therapy the main task consisted in gaining access to the deeper levels, beyond the splits, mainly by means of the least compromised and shut-off area, that of the physiological level. For this reason all the sessions at the beginning almost entirely consisted of long and continuous massages, and the re-establishment of a completely different breathing pattern from that which G. presented. His breathing, from being high thoracic, in chronic intake of breath, gradually became diaphragmatic with good expansion at abdominal level and with breathing-out neither forced nor controlled. In this way there emerged fairly soon sensations of trembling in the legs of tingling and itching on the face, and of movement and tickling on the navel. The great tension at the throat began to give way to intense fear (linked to a serious operation undergone at 14 years old), a deeply buried death anxiety and crying which had been held back and swallowed for too long. Only after this was G. able to come into contact with his “weakness” and with his need for help. Unexpectedly for the patient, his so muscular legs began to vacillate and no longer to support him; his voice became hoarse and not entirely open; the face began to assume more and more an expression of sadness and loneliness, and throughout the therapy symptoms from the childhood era began to come to the surface. This is to give concrete understanding of how psychosomatic regression leads back to extremely deep areas not only in the sense of age but also where, well below the splits, the original connexion between movements, emotions and their meanings still exists.

Only after much work on the weeping and on long-denied tenderness was it possible to, according to our model, to begin to intervene on the rage and aggression (unexpressed) except indirectly through feelings of diffidence and mistrust which were presented even if somewhat toned down, with respect to the therapy itself. What we would like to underline in particular is that the therapist in our opinion could not and should not have expected, at this stage, clear emotional manifestations (and still less out-bursts) on the part of the patient if one takes into account (looking at the diagram) the atrophy of this level compared with the others. If the functional schema has been correctly drawn up; it indicates that it would not be possible to rely on the postural level, too underdeveloped that is on expressive movements to be stimulated in sessions (eg. punching, kicking, stretching out of hands, beating cushions, facial mobility, etc.). The actions of the therapist, as one may deduce from this example, are always aimed at a widening of the perceptive field, at a shifting of the limits in the gamut of emotions, at a mobilisation of psychomotor expressivity; this means not so much coming up against character resistences as reading them as a lack of connection -with the other levels of the corporeal-Self. If is these connections with the other levels which can reconstruct the meanings of the patients repetitive and obsessive actions and, as a result, fill from below  and within, that void and that diminishing mobility which prevented both contact and the possibility of change. Therapy which works on character traits does show this up and throw it into relief, making room for negative transference, without neglecting to allow the patient to attempt to move towards the “new”, which can be laid down from the initial phase of therapy (new strategies, new ways of seeing and thinking, new perceptual horizons). This can be varied if whatever is perceived as “new” is in fact considered to be the effect of a joining up of parts which from childhood were cut off from awareness, though they remain visible in the store of peripheral and muscle memory, the so-called “body-memory”,

This psychosomatic regression can be arrived at through modes of intervention specific to each person rather than to each character “type”. Indeed these reflect the ways in which, in the individual*s history the various functional levels were altered and how in particular splits and disconnections within the corporeal-Self came about. Thus,  in this recent formulation, as opposed to the traditional reichian approach, there is no intention of proceeding from the negative and hostile  aspect towards a “good” internal nucleus, since in this new concept of personality the former are not to be found only on the surface, just as what is positive is not hidden and closed in only underneath. What is more the guideline of the therapy is no longer a relentless search for seccessive character traits to dismantle, each one under the other. The functional alteration of the corporeal-Self shows itself in complex fashion in symptoms and character traits which are not located in chronologically superimposed layers, but correlated amongst themselves throughout those parts of physical and emotional experience from which they originated and which contribute towards keeping them alive. For example intervention on one area of the body: the neck, will not reveal necessarily first those sensations and emotions which are more adult, and then, gradually going back in time, those which came earlier it is possible that what appears from the beginning an archaic emotion (not however in its archeological objectivity, but connected to the present situation of the patient and thus experienced “as if”) if the split between emotional and postural (in this case) is not very deep.

In other terms: the configuration of the material which emerges traces the configuration of the functional structure of the corporeal-Self. What comes out of this example, and what we wish to underline is the necessity of acting on several levels at once (though not on all levels at once, and not at random) in order to be able to get to the integrated areas of the original corporeal Self. This is possible if one chooses as a route that set of functions which present less encapsulation or, in other terms, less thickening of the false Self.