An introduction to the somatic energetic

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An introduction to the somatic energetic

  1. 1. AN INTRODUCTION TO THE SOMATIC-ENERGETIC POINT OF VIEW IN THE THERAPY OF TRAUMAPhilip M Helfaer, Ph.D.PART I. DESCRIPTIONNoteThese brief notes introduce the somatic-energetic point of view in its application in the individualtherapy of trauma spectrum disorders. They are also an orientation to the rest of the papers in thisseries which continue the development of the somatic-energetic point of view and which describeother applications.[Societal Context][An indication of the significance of the field of trauma studies in the U.S.A. is that The Division ofTrauma Psychology is among the fastest growing field in the American Psychological Association.One of the stimulants for this growth in the U.S.A., as no doubt elsewhere, is not simply the largenumber of returning soldiers from the wars in Iraq and Afghanistan, but the increasingly alarmingawareness that a large proportion of them are seriously disturbed as a result of exposure totraumatic stress related to military service. This makes the study (and the conflicts surroundingsuch study) of P.T.S.D., its diagnosis and treatment, of pressing importance. However, there areother influences that elevate trauma in professional awareness. Catastrophes, both natural(Hurricane Katrina) and terroristic (the 9/11 attack on the New York Trade Center) sent thousandsinto shock and traumatic stress even as the events were being witnessed in the media. Like thereturning soldiers, these events and their effects could not be avoided. Prominent social influencesalso increase professional engagement with the effects of trauma: the various organizationsrelating to establishing safety and equality for women in society and the related movements forprotection of children of both sexes.]Personal context
  2. 2. My own engagement with trauma studies and therapy came about in an entirely personal way. Ihad been aware of concepts of shock, dissociation, and trauma since early in my studies inpsychology and psychotherapy. However, when I experienced some aspects of the effects of myown developmental traumas, both emotionally and more exactly somatically, I gained a moreserious understanding of the significance of what “trauma” means as it effects the individual.The avenue by which I arrived at these insightful experiences was largely through my activeengagement with the discipline of bioenergetic analysis, which I designate here as a somatic-energetic approach to the study of the individual and to therapy. My professional engagementwith bioenergetic analysis resulted from personal experience of a serendipitous sort, certainly notfrom being exposed to it as a graduate student in psychology in the 1960’s. The serendipitousexperience occurred at the Esalen Institute in California, where I visited shortly after finishing myPh.D. There interesting people were teaching, experimenting with, and developing techniques forpersonal development that centered in inner experience and the body, rather than from acognitive or intellectual perspective. I found this very refreshing after so many years in academia.One day I had a very deep experience in which I found myself feeling very alive, at peace, joyful,and with a deep sense of connection with the natural world around me, which also felt alive. Tome, this was a highly desirable state. Could one live in such a state? Could it be the focus or goal ofa therapy? I set about exploring the possibilities, and in doing so embarked on what has turnedout to be quite a remarkable journey.Clinical Example and DescriptionsThe phrase somatic-energetic indicates that the therapy centrally involves perceptions andinterventions relating directly to the body, (as well as the mind), and aspects of the observed dataon which the therapy is based are energetic phenomena. An important example of an energeticphenomena is the manner in which the patient speaks.Mav, a gifted professional woman of sixty, shared her current status and life experiences in anintense, highly articulate, way that was charged with energy and a kind of inner pressure. As Ilistened to her profound, insightful, and thorough accounting, I respectfully asked several times tobe allowed to interrupt and invited her to pause, take a breath, and to feel her body and how shewas experiencing the pressured talk. At the end of each period of recounting, Mav experienced asense of what she described as a “collapse.”
  3. 3. Comments on these observations and interventionsI describe Mav as she is sitting and talking. We had shared our mutual observation of the energeticqualities inherent in her self-expression. First, and very obvious, was the rapid, driven effort, as ifto discharge a disturbing energy. This energetic trait, the therapist will realize that it is of essentialsignificance to Mav’s functional situation. We will return to it. Second, we shared notice of thesense of collapse after the completion of each segment of her recounting. This sharing ofobservation, or tracking, of the energetic phenomena is an essential therapeutic process.‘Collapse’ is a word that invites exploration. Initially, the therapist really does not know what‘collapse’ means to the patient, what she is expressing when she uses the word, or what thepatient experiences that impels her to describe her experience with this word. The therapist can,however, sense that the patient is alluding to a body-state. The therapist can sense this from theuse of the word, the manner in which it is expressed, and the therapist’s own bodily reaction tothe word or phrase containing the word. Developing the capacity to sense the allusion to the bodystate is an aspect of learning the somatic-energetic point of view. This is how one learns the“language of the body.” This is not remarkably different from learning to listen for unconsciousmeanings in the psychoanalytic process.A body-state is a non-verbal bodily experience that has the significance of depth in terms of itsconnection to unintegrated traumatic material and the unconscious. Bringing attention to thatbodily state is the most direct route to these deeper aspects of the patient’s functioning. It is alsoa safe, controlled, and integrating route (Eckberg 2000, p.49).The therapist, upon sensing thebody-state reference, has options as to how and whether to initiate further somatic exploration.The patient may or may not be able or ready to follow such an invitation. The body-state maystimulate further disassociation at this point, and this may interfere with her ability to report on abodily state or bodily experience, and her mind will deflect her into associations, narrativememories, or another topic. In Mav’s case, her deep contact with herself allowed a therapeuticallysignificant exploration of the experience of collapse.Session continuedMav recounted that at the moments she “collapsed,” as for example, when she had completed aseries of historical associations, she felt on the verge of a kind of dissolution of her ego and afalling. These were not pleasant releases or relaxations. To her, they represented the possibility of
  4. 4. insanity. Mav considers that both her parents were periodically psychotic during her growing upyears. Would she be like them? In her mode of adaptation, she believed that as long as she wasmoving and on the go, she would remain functional. She would also however, remain in a state ofdisassociation and tension, unable to relax, give in, be more comfortably in her body, and trust herinnate functional capacities, all of which contributed to her state of ongoing suffering and pain.Further commentsAll these explorations and elucidations evolved as Mav sat and described her current and ongoingexperience. A description of ongoing, daily experience will include accounts having to do withrelationships, work, love, and aspects of self-regulation such as eating, sleeping, and exercising. Itshould also include accounts of – as well as expressions of – the emotional aspects of affectregulation. These include moods, feelings, and hedonic tone. These are of the greatest significancefrom an energetic point of view. Feeling is life. The lack of feeling indicates a lower energetic lifestate, and this implies inhibited respiration. A depressive tone is a marker of the state of life in theorganism. Often it is associated with anhedonia, the lack of the capacity for pleasure, one of themost unfortunate states associated with trauma spectrum disorders and other types of problems.All these states and conditions need to be observed by the therapist, and the patient’s interest,involvement, and curiosity about them are to be mobilized. It is the therapist’s task to involve thepatient in somatic-energetic explorations and interventions that engage and energize these states,and lead to developmental explorations. This is a mutual enterprise. A significant form of learningand development for the patient is to arrive at a functional realization of the relationship betweenan inner experience and the somatic-energetic process which, in effect, mediates between theconscious experience and the body.I am elucidating and demonstrating that the therapeutic process follows and focuses on thesomatic-energetic process, from moment to moment in the ongoing session. Associations,narrative memories, and recountings of current experiences are a background interwoven withthe somatic-energetic process. This background is not ignored. The therapist tracks it. In doing so,the therapist has the opportunity to observe whether and how the various narrative, verbalthemes correlate with and further elucidate – or are disassociated – from the somatic-energeticprocess that is emerging. This process – tracking and correlating – is of the utmost importancetherapeutically. It allows the process of the therapeutic session to remain on a meaningful track. Ibelieve this aspect of the work, amongst others, is unique to a somatic-energetic approach.From sitting and talking, we moved to another phase of work together. At my suggestion andMav’s agreement that it felt like the right time, she moved to a standing position. Standing and
  5. 5. feeling the feet on the ground is a simple, direct way to have an overall experience of one’s ownbody.The session continues to developShe stood, and I invited her to track and report body sensations. This proved to be difficult. It wasas if inner pressures and forces diverted her from attention to her body, and she quickly went intoassociations, memories, and descriptions each time she returned her attention to her body.Comments and a characterological formulationIn bioenergetic analysis, this standing position, with attention on the feet, is considered agrounding process, and it has energetic significance. The move from sitting to standing allows thepatient to experience her body in gravity and it reveals to the therapist how the patient holdsherself and how she connects to the floor through her feet. All this reflects her adaptation tostress, and often just how chronically stressed she may be, as well as the characteristic tensionsthat reflect the stress. These are observable, often characteristic, aspects of the individual’sfunctioning. Learning to look at the individual in this way is an aspect of learning the somatic-energetic point of view.As Mav is standing we gain further perspective on something we observed earlier as she wassitting and talking. There is a kind of inner charge or excitation which she is able to describe. Itspreads through her thorax from the diaphragm. It is a charge that seems to be seeking an avenuefor discharge, but does not have a natural channel available for discharge. In addition, we now canobserve a new aspect or impact of it. It has a distracting effect on Mav’s ability to consciouslyfocus on the experience of her body. We could even say the effect is fragmenting, or chaotic, inthat pieces, rather than a whole, emerge in Mav’s somatic reporting about herself in therelationship with the therapist.These observations add confirmation to an impression that began to emerge earlier. A degree andtype of fragmentation characterizes Mav’s sense of her own body. An inner force or energy is partof what drives that feeling, and in addition, there is a sense of dissolving and falling that canemerge when Mav’s talking quiets for a moment. These experiences are quite typical for traumaspectrum disturbances. We will learn more about it in the next phase of the session.
  6. 6. A deepening phase and integrationEventually, after experiencing this kind of chaotic and pressured experience, I invited Mav to lie onthe mat, and focus on her breathing. At this point, she was certainly well aware of the innerpressure. As a result, after she lay down, she soon began to cry deeply. As Mav lay on themattress, her knees where up, so that she could press her feet into the mattress, to maintain asense of her feet. Soon, following her body, she allowed a strong rhythmic rocking motion todevelop from her pelvis. I said, “Good, an integrative movement.” Later, I learned that this and afew other simple words of encouragement were helpful and appreciated.Pain, body memory, insight, and further integrationAt the same time, something was occurring that, to me, was quite remarkable. This was thetransformation of a sense of pain into memory with insight. Mav began to speak of how much painshe was feeling and often felt. When I asked her where in her body the pain was experienced, shesaid it seemed to have no “where” to it. There were no specific body sensations. She then said thatit had to do with “enduring.” Day in and day out, she had to endure a horrible, torturousatmosphere in her childhood home in which she was constantly subjected to parental craziness.She was regularly related to with hate, emotional and physical sadism, and the parents’exploitation of her for their own narcissistic needs. We shared the belief that the pain she hadbeen experiencing was what we call a “body memory,” a direct reflection of what she hadexperienced and “endured” as a child and adolescent.Comments: body memory and character formulationA body memory is a memory that is remembered as a sensory experience, usually due to energeticor emotional arousal. The work of somatic-energetic therapy often awakens such memories.These memories are recorded in the usual neurological memory channels of the brain. They arenot “narrative,” or explicit memory. They are encoded as limbic, implicit, or procedural memory(Scaer 2001, 2005). This means they emerge as sensation or feeling, often without a picture orstory. The familiarity of the sensations may bring a story or picture to mind. As commonly noted,much of traumatic memory is of this sort.
  7. 7. Scaer’s (2005) concept of somatic dissociation suggests a possible neurological mechanism thatilluminates the body memory phenomena. Somatic dissociation is a function of changes in theautonomic innervation of specific end organs(muscle fibers, or etc.). When a muscle group thathas been dissociated is stimulated through somatic-energetic interventions, it may eventuallystimulate limbic memory channels through effecting autonomic innervation.The energetic impact of Mav’s parents’ psychotic way of relating to her is “stored” in Mav’sneurology, and it is experienced as a constant painful inner pressure, anxiety, or drive excitation.There is no normal avenue of release or discharge for it, just exactly as Mav could only endure andsuffer her early experience. A good-enough holding relationship allows the child’s emotionaltensions to be held and allowed to relax or release. The holding relationship is the child’sstructural requirement allowing for integration of emotional experience and the learning of self-regulation. To be under constant attacks of various kinds and to endure became the model, forMav, for what relationship is. The pressure was unrelenting and kept her on the edge of herbiological resources, always with the threat of fragmentation or of the ego being overwhelmedand dissolving. There remains aroused in her body a strong fragmenting energy which constantlydrives adaptive efforts in the hope of soothing connection and relief.There was one saving grace. Mother supported her intelligence and school work. Also, by takingon the role of caretaker of younger siblings, she developed other relational and adaptive skills.With these skills, she survived as an intact person, and was able to develop herself, but alwaysunder enduring traumatic stress.Eckberg (2000) also observed the transformation of an experience of pain into some other kind ofbody sensation and a memory.A client was experiencing body memories associated with a childhood memory of sadisticpunishment. She experienced the sensations as painful. After working through the memories anduncoupling the terror and immobility from the sensations (which took many sessions), she said,“Why, they are just sensations; they are not really painful.” (p.54)The relationship between various kinds of chronic pain syndromes and trauma has been exploredneuropsychologically by Robert Scaer (2001, 2005). The alleviation of some types of these painsyndromes through somatic-energetic therapy may be considered clinically demonstrated.
  8. 8. Note on this sessionThe extensive depth and integrative potential of this session are made possible by threeconditions, (amongst other factors). We had created the opportunity to work for an extendedperiod of time, about three hours. Mav, herself, has had extensive therapy and has continued todo her own therapeutic work over many years. She was highly motivated and ready to makeimportant changes in her life. In an ordinary, ongoing therapy, this work would require weeks, ifnot months. As an extraordinary session, it provides a unique window into the process of somatic-energetic therapy.On somatic-energetic therapyI believe that a somatic-energetic therapeutic session of this sort reaches the limits of what istherapeutically possible in the most positive sense. In the bodily, emotional, and sensoryexperiences that emerge are seen the deepest sources of the ongoing traumatic stresses thatconstantly created pain, tension, and suffering in Mav’s life. Even more important, we are notsimply observers of the sources of suffering. The somatic-energetic experiences that emerge andthe way in which they emerge are the steps in releasing ancient painful reactions that have beenlocked into Mav’s neuropsychology since childhood and adolescence. These sensations emerge asreleases of tension within a holding relationship. Mav feels tangible relief at the end of thesession.Not only is tension released, there is integration of previously unintegrated traumatic material. Inthis session, integration occurred through bodily movement, and through the transformation of akind of body sensation into a conscious memory that connected with historical narrative. How canbodily movement foster or be an aspect of integration? This can be understood immediately if weremember the situation of a child in Mav’s position: movement, expression, appropriate use ofaggression, even free expression of feeling must be inhibited in the service of adaptation,maintenance of the semblance of attachment to the parents, and even survival of the integral self.Under these conditions, the autonomic nervous system, unable to mobilize either for fight or flightgoes into freeze. Somatic energetic work can release a freeze through breathing and movement,allowing a part of the early trauma reaction to be completed.
  9. 9. One important physical sign of the relief Mav experienced deserves mention. This has to do withher breathing. Often after a session, there is an easier, deeper breathing, along with the feeling ofrelief. Mav’s breathing, she reported, for many years was what bioenergetic therapists refer to as“paradoxical breathing.” This is an uncomfortable breathing in which the lower abdomen, insteadof extending and expanding with inhalation, contracts and is sucked in. We had noted thisbreathing when Mav stood up. When she stood again after her work on the mat, we weredelighted to see that her breathing had become normal!Further applications in individual therapy: contextual noteWe can call Mav’s posttraumatic syndrome, or her “trauma spectrum disorder,” developmental, inso far as the actual trauma occurred in childhood and adolescence, and the disturbance developedout of the necessity of a development based on adaptation to the effects of the traumas. In post-traumatic adaptations, the organism calls on all the biological and psychological resources at itsdisposal. Traumas of course can and do occur outside of the developmental context for childrenand, of course, adults. Somatic-energetic work can be used in relation to posttraumatic adaptationin these instances as well.Victims of CrueltyMaryanna Eckberg (2000) was a courageous pioneer in the use of somatic-energetic therapy withpeople with PTSD. One group she worked with were people who had been subjected to politicaltorture or the loss of family members to political murder from Central and South America. She hasgiven a full outline of the approach to take, the stages of therapy, and the somatic energeticimpact of torture on its victims. Her work is another testament to and clinical demonstration ofthe importance and efficacy of somatic-energetic work with severely traumatized individuals. Herdescriptions are completely applicable to combat veterans. For our present purposes, I single outone heartfelt description to quote.I truly do not know what I would have done with these two (survivors of political torture) had I nothad the expertise to work on a physical level. I told them that they did not have to talk ... (T)heemphasis was on helping the client to let down while exhaling, to sense the movement of energydown the body while doing this, to ease the movement of energy downward, to encourageelongation and expansiveness in the tissue, and facilitate parasympathetic activity. ... Their
  10. 10. symptoms began to improve ... Both began to talk ... while staying grounded in their bodilyexperience. (p. 48)PART II. CULTURAL, SCIENTIFIC CONTEXTA surface phenomenon: a split contextBesides bioenergetic analysis, there are other significant somatic (not necessarily energetic)approaches (Levine 1997; Ogden, et. al. 2006). Bioenergetic analysis is distinguished by a morethorough analysis of the somatic-energetic aspects of personality, by a developmental perspective,and by a dynamic and functional conception of character and personality. It is thus acomprehensive (as well as the oldest) approach to the study of individual functioning in terms ofsomatic-energetic process.To those of us who work with and understand the somatic oriented therapies, nothing could bemore self-evident than that this is the most appropriate approach to working with traumaspectrum disorders. Clinical outcomes are positive. From a theoretical perspective, traumaticmemory is commonly understood to be encoded as sensation, body feeling, and other sensoryexperience. The most direct approach to these “unconscious” memories is through the senses andenergetic processes. Empirical evidence of efficacy is slowly developing (Koemeda-Lutz, et.al.2004).Today’s professional context, however, is peculiarly characterized by a gross split. The somatictherapies are not taught or practiced in academic, veterans, or medical institutions. Two recenthandbooks on PTSD (edited by essentially the same people, Foa, et. al. 2009; Friedman, et. al.2007) make no mention of somatic oriented therapies. At the same time, somatic approaches areadvocated by a growing number of practitioners and by a growing number of recognized experts(Scaer 2001, 2005; van der Kolk 1994). The International Institute for Bioenergetic Analysis has aprofessional membership of certified therapists of something over one thousand members inEurope, and North and South America. There is a group in Israel, also New Zealand.Quiet, please, session in progress
  11. 11. Multiple issues lie beneath this surface, some having deeper significance than others. At the moresuperficial end of the spectrum is the consideration that most institutional offices are not set up toaccommodate the movements or sounds (even deep crying) that might ensue from a patientworking through traumatic memories in a somatic-energetic therapy. A deeper side of the sameissue is the impression that most professionals, frankly – at least the ones pursuing graduate ormedical studies – do not have the stomach for intense emotional expression accompanied by deepcrying, shouts, or even screaming. In addition, a professional who does pursue training in, forexample, bioenergetic analysis, is not likely, as a result, to gain further promotion or influence inhis or her institutional setting. (In contrast, for many years, psychoanalysts, at least in the U.S.A.,were often senior figures in psychiatry and academic medicine. Nowadays biological psychiatry ismore dominant in terms of academic position and research grants.) All of these issues havenothing to do with scholarly, scientific, or clinical substantiation of the approach. They are areflection of the culture and sociological characteristics of the milieus in which trauma studiestend to occur and in which professionals reside.Who and what are we treating? And is it a treatment?A treatment in bioenergetic analysis begins with observation of the patient, if patient is the term,and he or she is a co-explorer in the process. Cognitive behavioral approaches, for the most part,begin with a model of what the “disease” is, and proceed with the protocol for it. ProlongedExposure Therapy for PTSD (PET) is a paradigmatic example. The model is based on the idea of the“fear structure.” Theoretically, the treatment deconditions the various stimuli associated with thefear structure. It is not my purpose to criticize this therapy, but to contrast it with the significantlydifferent approach of bioenergetic analysis.In a bioenergetic analysis, I want to know who the person is and exactly how the trauma spectrumdisorder is functioning in his or her person. This is a demanding process for both therapist andpatient. However, it offers the possibility of the widest range of opportunities for (posttraumatic)growth. In addition, it offers the widest range of opportunities for learning about trauma spectrumdisorders: actually what they are in terms of how they effect the individual, how they function inthe individual, how they arise in the first place, and how they develop over time. These, I believe,are the significant areas for ongoing research.Even other somatic therapies begin with a preconceived model, often having to do with autonomicfunctioning. Now, there is no question that the vicissitudes and disturbances of the autonomicnervous system (a.n.s.) are of the greatest significance in this field. That is not at question. Thefirst questions are still, Who is the person and how is he or she functioning?
  12. 12. Why is somatic-energetic therapy not the primary model?There are two “cases” to consider in relation to this question. One has to do with the widespreadadoption of cognitive-behavioral therapies amongst academic psychologists. The other has to dowith the psychoanalytic tradition where, in fact, the somatic-energetic point of view originated.Jonathan Shedler, an American psychologist and psychoanalyst, reports on the eagerness withwhich the academic community, excluded for so many years from organized psychoanalysis,greeted news of the efficacy of non-analytic techniques (Shedler 2010, p.98); and theypromulgated the notion that psychodynamic therapy was not supported by “scientific evidence.”A brief quote from the conclusion of Shedler’s (2010) extremely useful article may suffice for oursummary of the first “case.”... the available evidence indicates that effect sizes for psychodynamic therapies are as large asthose reported for other treatments that have been actively promoted as “empirically supported”and “evidence based.” It indicates that the (often unacknowledged) “active ingredients” of othertherapies include techniques and processes that have long been core, centrally defining featuresof psychodynamic treatment. ... p. 107It is not surprising that “the body,” especially the body-as-the-person, has not found much place inthe curricula of academic psychology departments.Somatic-energetic therapy originated with Wilhelm Reich (1897-1957). Reich was – let me say –not popular amongst his psychoanalytic colleagues. About the time he was first setting forth someof his ideas having to do with the body in psychoanalysis, he was ejected from the psychoanalyticassociation. He pursued the path of the lonely genius subsequently, albeit always surrounded bystudents and followers.Interestingly enough, even his worst enemies (Chassequet-Smirgel and Bela Grunberger 1986, p.178) agreed to the validity of his somatic observations. Indeed, contemporary psychoanalysts dotoo, however, without even a nod or a wink in Reich’s direction. W. W. Meissner, a distinguished
  13. 13. senior psychoanalyst in Boston, U.S.A., wrote a series of articles about the body in psychoanalysis(1997,1998a, 1998b, 1998c). His statement that the self is a body-self is appropriate for abioenergetic textbook:.... Both of these aspects (self as subject and self as object) are inextricably immersed (sic) in bodilyfunctions, so that any comprehensive theory of the self has to connote the embeddedness andintimate integration of the self as inherently bodily. I will argue .. that all psychic functions areinherently involved in bodily processes of one sort or another. All actions, including psychicactions, are inherently bodily, and if the locus of agency is the self ... the role of the body as aninherent component of self-organization cannot be left out of consideration. Further, any conceptsof self regard or self representation, even as far as my own self reflection goes, are not completeand cannot be divorced from awareness of my own body and its functioning. And it goes withoutsaying that any interaction with others is necessarily mediated by bodily functions – I see, hear,touch others as bodily objects, just as they see, hear, and touch me. This is the stuff out of whichobject relations are compounded. I see the other as a bodily object, and seeing is a bodilyfunction; I hear the other when he speaks, and my hearing and his speaking are both bodilyfunctions. (1997 pp. 420-421.)This is as clear and eloquent a statement as there can be, and it could be taken as the first premisefor a theory of bioenergetic analysis.Meissner (1997) also takes some pains to clarify the significance of the body in Freud’s thinking:There would seem be little room for argument that Freud envisioned the connection of the mindto the body as central to his thinking about psychic functioning and psychopathology. This aspectof his theory is clearly reflected in his thinking about instinctual drives, his theories regardingaffects, particularly anxiety, his theory of hysterical conversion, and in his understanding of theego as a body ego. (p.424)I find it remarkable that, after establishing unequivocally that the self is a body-self, he then alsosimply and flatly states that in psychoanalytic therapy, the body takes a “backseat:”
  14. 14. On the couch bodily manifestations continue unabated. ...If these behavioral manifestations are important as direct expressions of bodily processes, theymust take a backseat to the specifically verbal behavior that constitutes the core of observationaldata in psychoanalysis. (p.281 IV)In other words, we see, but we do not make use of these data in psychoanalysis; they are not thebasis for determining therapeutic interventions. How did this come about? Meissner reflects theaccepted, disciplined analytic posture, implying that analysis requires these boundaries anddiscipline. Why is it this way? Why did analytic technique, based on a psychoanalytic theory of selfas body-self, omit bodily, somatic-energetic interventions as central to the practice? That this ishow it stands, we know, but, to my knowledge, no one has remarked on how strange it is! BothFereneczi and, much more so, Reich, pointed the way to a technique with a somatic orientation.Their lead was not followed.Of course, I’m implying something that, historically, is not the case. I’m implying that bioenergeticanalysis – given that the self is a body-self – should be the primary therapeutic model, the one thatputs somatic-energetic intervention at its core. In fact, for over one-hundred years now, therehave been, as Meissner points out (1998 c, pp 278-79), two bodies in the therapeutic consultingroom. I am aware that this “should” is paradoxical and provocative. In relation to thepsychotherapy models practiced in the various institutions I mentioned in an earlier section, we inbioenergetics are the ones practically in the position of having to introduce ourselves. I haveoutlined a perspective that perhaps casts a new light on this situation. From this perspective, thecontemporary situation might appear a bit paradoxical and even odd. In any case, I believe, thisperspective poses the questions above and a further question: How and why did somatic-energetic technique and theory become split off from psychoanalysis?Confusion of tonguesI do not know the answers to these questions. I believe, nonetheless, that the questions are worthasking. Maybe they will suggest something interesting and worthwhile. In any case, given thedifferences in technique and theory, I believe it was necessary and advantageous for bioenergeticanalysis to develop separately and in its own milieu; perhaps this is still the case. Now, however, Ialso believe there would be great gains, especially in the treatment of trauma, if bioenergeticanalysis and other somatic-energetic therapies were to find a place within various institutionalworlds. For this to happen, the questions need to be pursued.
  15. 15. Recently, when I spoke with a professional therapist about the somatic-energetic approach, shesaid, “You are talking a different language.” Really? Is there something about bringing the bodyinto the psychotherapy field that introduces a new language? As if “the language of the body”were not a part of “regular” language? Do we enter a different land, a different culture? Maybe inthe same way as Freud suggested that in “the land of sexuality” it is always gray and raining? Ormaybe worse in this case?It is certainly true that we introduce a new perspective, or as I have been calling it, point of view. Itis also true that we talk about different phenomena, bodily and energetic. However, these, asindicated in the discussion of Meissner’s writing, are not phenomena that are not observed inother therapies. In our therapy, they are looked at differently, and they are put into their(rightfully, as I see it), core place in the therapy.Sandor Ferenczi (1873-1933) “was one of Freud’s closest collaborators” (Van Haute and Geyskens2004). He seems to have had some influence on Reich. In any case, like Reich, he was original andcreative, and like Reich he returned the idea of sexual trauma to being the central etiologicalfactor in neurosis. He wrote a remarkable paper called “Confusion of Tongues” (1932). I find in it areflection of my colleague’s comment, “You are talking a different language.” Ferenczi is referringto the radical difference between a child seeking or expressing warmth, love, and tenderness to aparent or other adult, and the adult responding with adult sexual passion. They do not speak thesame language.Is it possible that the intrinsic difficulty, avoidance,shame, and horror of facing traumatic sequelaeare at work in the avoidance and rejection of the body in the field of psychotherapy? I am inclinedto believe so. Disassociation and denial are really somatic-energetic phenomena: they alwaysinvolve the denial or disassociation from specific bodily experiences, sensations, or emotionsrelated to them. In the case of complex developmental traumas, denial and disassociation canreadily become embedded in characterological developments. They then become difficult to sortout from the whole characterological background. For people who become therapists, includingsomatic-energetic therapists, this kind of development, in my experience, is hardly uncommon.Inevitably, they themselves avoid aspects of their own body experiences. In this and other ways,the profession itself can become complicit in supporting a prevailing social ethos of denial, even ofdisassociation. While this scenario may seem speculative, it corresponds with much of my ownexperience, personal and professional. Identifying and working with disassociation, denial, and“forgetting” remain challenges, as do the whole range of traumatic sequelae, despite their longhistory in the field of psychotherapy.
  16. 16. PART III. FOLLOWING PAPERSSeven papers are planned for this series.1. The Somatic-Energetic Point of View in the Therapy of TraumaThis paper, (the present paper), is meant to serve as an introduction. It offers a detaileddescription of an intensive, in-depth session from a somatic-energetic point of view. It discussesthe scientific and cultural context of this type of therapy.2. Positive Development for Persons with Trauma Spectrum DisordersThis paper describes the application of somatic-energetic therapy in a group context. It shows theparticipation of the whole person in the group process, body and soul. It discusses thedevelopment of the group as a community and the significance of this. The paper also discussestheoretical features of the energetic point of view and its development. This paper is published inThe USA Body Psychotherapy Journal, Vol. 9. No.2 2010.3. A Course of Treatment for Trauma Spectrum Disorders: A New Whole Person ApproachThis paper also describes the application of somatic-energetic therapy in a group context, bringingin other aspects of bioenergetic analysis and the development of the group.4. Treating Trauma Spectrum Disorders: A New Approach [brief description]This paper is a brief summary version of (3). I can be an “appendix” or a “quick look”.
  17. 17. 5. Expanding Cognitive-Behavioral Techniques with Somatic-Energetic TechniquesThis paper suggests an application of somatic-energetic techniques in the use of cognitivebehavioral approaches. Many of the cognitive-behavioral approaches use breathing, grounding,and mindfulness, all of which are best understood in a somatic-energetic context. Further, thecognitive behavioral protocols require that the therapist observe, understand, and relate to theindividual being treated. Bioenergetic analysis offers an excellent training in these factors essentialfor the successful outcome of therapy.6. Self-Respect in Somatic-Energetic Treatment of TraumaTo be written. Self-respect is a body concept (Helfaer 1998/2006). It represents a positive way ofrelating to and identifying with the body, and can be seen as the essential underpinning of positivemovement in any therapy.7. Scientific Evidence or Social Change? Introducing a Somatic-Energetic Therapy into theInstitutional ContextTo be written. This paper will address the paradoxes, methodological complexities, and socialobstacles to introducing somatic-energetic therapies into the social context of the institutions ofacademia, medicine, and veterans rehabilitation.Papers are or will be posted on the website of the Israeli Society for Bioenergetic Analysis at:www.bioenergeticanalysis.org.il .ReferencesChasseguet-Smirgel, J. and Bela Grunberger. 1986. Freud or Reich? Psychoanalysis and Illusion.New Haven: Yale U. Press. p. 178.Eckberg, Maryanna. 2000. Victims of Cruelty. Somatic Psychotherapy in the Treatment ofPosttraumatic Stress Disorder. Berkeley CA: North Atlantic Press.
  18. 18. Foa, E.B., Keane, T.M., Friedman, M.J., Cohen, J.A. 2009. Effective Treatments for PTSD. PracticeGuidelines from the International Society for Traumatic Stress Studies. Second Edition. NY:GuilfordFriedman, M.J., Keane, T.M., Resick, P.A. Eds., 2007. Handbook of PTSD. Science and Practice. NY:Guilford.Helfaer, Philip M. 1998/2006. Sex and Self-Respect, The Quest for Personal Fulfillment. Alachua,FL: Bioenergetics Press.Levine, Peter A. 1997. Waking the Tiger. Berkeley CA: North Atlantic Press.Margit Koemeda-Lutz, Martin Kaschke, Dirk Revenstorf, Thomas Scherrmann, Halko Weiss undUlrich Soeder. 2004. “Preliminary Results concerning the Effectiveness of Body-Psychotherapies inOutpatient Settings – A Multi-Center Study in Germany and Switzerland.” www.eabp.org (B-PResearch) Also published in The USA Body Psychotherapy Journal 2005 (4) 2, 13-32Meissner, W.W. 1997. “The Self and the Body: I. The Body Self and the Body Image “.Psychoanalysis and Contemporary Thought. Vo. 20. No.4. pp. 419-48.___________.1998a. “The Self and the Body: II. The embodied self – Self vs non-self.”Psychoanalysis and Contemporary Thought. Vol. 21. No. 1. pp. 85-111.___________.1998b. “The Self and the Body: III. The body image in clinical perspective.”Psychoanalysis and Contemporary Thought. Vol. 21. No. 1. pp. 113-146.___________.1998c. “The Self and the Body: IV. The body on the couch.” Psychoanalysis andContemporary Thought. Vol. 21. No. 2. pp. 277-300.Ogden, Pat, Minton, K., Pain, C. 2006. Trauma and the Body. A Sensorimotor Approach toPsychotherapy. NY: W.W. Norton.Scaer, Robert. 2001. The Body Bears the Burden. Trauma, Dissociation, and Disease. Binghamton,NY: The Haworth Medical Press.___________. 2005. The Trauma Spectrum. Hidden Wounds and Human Resiliency. NY:W.W.Norton & Co.Shedler, Jonathan. 2010. “The Efficacy of Psychodynamic Therapy,” American Psychologist. Vol.65.No. 2. Pp. 98-109.Stern, Jessica. 2010. Denial, A Memoir of Terror. NY: HarperCollins.van der Kolk, B. 1994. “The Body Keeps the Score: Memory and the Emerging Psychobiology ofPost Traumatic Stress,” Harvard Review of Psychiatry, 1994, 1(5), 253-265.
  19. 19. Van Haute, P. and Geyskens, T. 2004. Confusion of Tongues. The Primacy of Sexuality in Freud,Ferenczi, & LaPlanche. NY: Other Press.

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