The rain was coming down in sheets as if a dam had burst far above the dark clouds. It was a dreary November afternoon, buffered only by the warm glow of my office lamps and the soft gold upholstery of the chairs, as Ethel and Bob enter. They had started therapy two sessions before because their sixteen-year-old son, Tom, was refusing to go to school and seemed to rebel at almost every reasonable act of parenting.
The two parents presented very different physical appearances. Ethel, I noticed, looked depleted—a slender pale woman with a slightly sunken chest. She had entered the room like a delicate, timid bird, greeting me with a certain deference. I had been struck by the softness and tentativeness of her handshake and her general demeanor. Bill, by contrast, entered in a positive, even determined way, as if he and the ground were somehow over-connected. His eyes were penetrating and he greeted me with a sturdy handshake.
During that first and the succeeding session we had begun an initial exploration of their own intergenerational histories and the differences in their individual family-of-origin parenting styles. Among other important facts, I learned that Bill’s father had largely been absent; Ethel’s had been present in a very strong way. Now was the moment to explore some of the concrete results of those differences by bringing the treatment into the present and its problems.
I was glad when Bill began the session by jumping into the moment: “I don’t think we are getting anywhere here. We still haven’t found out what we need to do with Tom. Ethel just won’t support me in laying the law down to him.”
As he was speaking, I saw Bill’s jaw tighten, his shoulders tense, and his eyes hardened into a near glare as he turned to face Ethel. To my “mind-body” perspective, these signs, the silent language of his body, spoke his message louder than the words he used.
“So Bill, when you say Ethel won’t back you up and lay down the law, what is that like for you?”
“Terrible. I feel I’m stuck either way. If I go ahead with my sense of what to do, Tom won’t pay much attention to me, because his mother disagrees. She will undermine my efforts. And if I go along with her, then I think I’m doing the wrong thing.”
I had explained to both Bill and Ethel at their initial interview how, in addition to a multigenerational approach to family therapy, I utilized a somatic perspective. In fact, they had come to work with me because of that reason, having been referred by a couple I had worked with previously. Because they both had expressed an interest in the mind-body connection, I felt free to address Bill’s awareness of his somatic reality.
“Bill, what else happens? What do you sense in your body, right now, as you speak about this?”
“Well I feel all bound up, like I’m stuck.”
“Bound up how? How do you know that—in your body?”
“Well, I feel tight, and like I have all this need to do something and she is stopping me. She won’t cooperate!”
“Tight where? Where in your body are you tight?”
“In my shoulders and back, my arms.” At this point Bill leaned forward slightly, lifting his arms as if he was reaching out in a futile gesture. Then they dropped down in his lap, seemingly disconnected from the rest of him.
“Bill, I’d like to come back to you in a minute. Right now I’d like to check in with Ethel about her experience before we go further working with you. Is that okay for now?” Looking slightly relieved to be out of the center of attention, Bill nodded and leaned back in his chair.
“Ethel, how do you see the situation? What happens for you when you hear of Bill’s frustration?”
“Actually, I become scared when Bill is so intense that I should do things his way. I’m not sure his ideas about ‘shape up or ship out’ are the way to go with Tom. I think he’ll just drive Tom out of the home.” As Ethel spoke, the color began to come back in her face as if blood was returning.
“What is it like, here, now, as you listen to Bill?”
“Scary. I just feel I’m torn between my son and my husband. I don’t agree with either of them, but they seem to be locked into this contest—‘who’s going to win.’ ”
“Ethel what are you aware of in your body, as you speak about this?”
“Well, my hands are cold, I don’t feel very strong and I’m trembling inside.”
“Trembling where?”
“In my torso, inside.”
“Would you be willing just to focus your awareness on the trembling that you experience for a few moments?” She nods.
“Just be aware of the experience of the trembling.” As I observe Ethel, she begins to tremble and shake, her torso, neck, and head are shuddering, and then her feet rhythmically begin to twitch. At this point I ask her to stand up and sense her feet on the ground—because I know that without her grounding the intense sensations of the trembling, she may be more overwhelmed than ever.
“What do you notice as you do this, Ethel?”
“My legs. I realize I was not feeling them—as if they were not there.”
“And what is it like to have them there now?”
“I feel so much different.” (Her trembling begins to slow down noticeably.)
“How?”
“As if I am connected to the floor.” (Her voice becomes deeper and her head, which had been leaning forward, now begins to come up.)
“What would you be willing to say to Bill from this sense of support, from your grounding and support in your legs?”
(She looks at Bill.) “I love you both and I don’t think dealing with Tom this way will work. I want you to listen to my ideas also.”
“Will you say that again and reach out to Bill with your arms?” (This movement is a typical somatic expression of “reaching out” to another. We learned it as a part of our natural development as a child and it is, therefore, a usual way of expressing ourselves when we are ready to receive, to be open to take in. In somatic developmental psychology, such a typical human movement is known as a “psychomotor movement.”)
She reaches out to him and then brings her arms down to her sides.
“What is your experience now?”
“I feel more solid, as if I’m inviting him in, into working it out together.”
“What do you sense in your body now?”
“My legs are tighter. They have more energy, more sensation, as does my back.”
“Would that be enough for now?”
“Yes.”
“I would like to turn to Bill now. Is that all right?” (Nods.)
“Bill, what happened when Ethel reached out to you in this way?”
“Well, I don’t know, I have not really heard her say ‘let’s work it out’ before.”
“What did you sense in your body?”
“I don’t know.” (I had noticed that Bill’s shoulders went up and tightened, his breathing was held, and his facial color had become slightly red when she spoke to him.)
“What happens now in your shoulders and the back of your arms?” (Bill’s posture, movement, and build had alerted me to the possibility that he might be operating from some held anger and judgment, a position of you’re wrong, I’m right! Now I want to test my assessment.)
“Now that I notice them, I can feel they are tight.”
“Will you extend your arms for a moment as if pushing something away, pushing away what you don’t want, and notice how your arms and back of your shoulder muscles feel as you do that?”
Bill nods, pushes, and then brings his arms back in.
“Okay, now will you do that again, and if you had words for what this action means, what would they be?”
“Back off, don’t push me!” (Face gets red, voice elevated.)
“What happens to your shoulders and arms?”
“They are more relaxed.” (This movement is intended to establish a better sense of boundary for Bill—activating the posterior deltoids and triceps is a movement joining the words so as to bring body and mind together, allowing Bill a further expression of his felt meaning. The results of such mind-body dramatizing nearly always include a sense of relief, deriving from a closed gestalt, a sense that both parts of the organism have been joined, and therefore, the expression of self is more complete.)
“I’m more relaxed!”
“Where? How do you know that?”
“Well, I mean that I’m more relaxed in my shoulders and the back of my arms, but also I’m feeling that my torso, I mean I’m noticing my torso more.”
“What happens now when you think about what Ethel said, and how she reached out to you?”
“I want to try and hear her more. I don’t think I will agree with her, but we do need to find a way to work this out together!”
“What happens when you think of not working it out together?”
“I tighten up in my shoulders and arms and back, and I think I’m on my own again. Alone!”
“Ethel, what happens when you hear that?”
“I just want to reach out to him,” (She turns to Bill.) “—to you. I know you had that alone and threatened feeling growing up, and I don’t want to be a part of reinforcing that. At the same time, I need to have you hear that I have some other ideas about how to be with Tom.”
Ethel had grown up with a father who was a hard-driving, self-made man with strong opinions. She found it difficult to express her opinions and hold her ground with her father. This pattern, of not being able to have enough impact with her father, someone close to her existence in childhood, has been replayed in her relationship with Bill, and dramatized in her body.
“Bill, what is it like to hear this?”
“A little cautious, but maybe it will work. It’s worth a try.”
This excerpt of Bill and Ethel’s third session illustrates in a small way how utilizing the story the body tells can assist a person’s ability to generate new insights, and also become more resourceful dealing with current issues in the family. Bowen family systems theory teaches us how to use a multigenerational perspective to direct our attention and curiosity to how the family is a system of interrelated patterns. Therapy includes examining these patterns, and particularly how they condition or affect individuals’ sense of connection in their relationship. Of particular interest is how connection was dealt with in their original family, the legacy of the family’s emotional field, and its continuing impact on them as individuals in relationship. As is well known to professionals in the field, a partial list of themes usefully explored include how the family-of-origin handled loss, grief, and abandonment, as well as boundary and triangle issues. In such explorations, clients look at their own “stories,” their family-shaped personal realities that continue to be theirs both in regard to themselves and their present world. But if clients are to move beyond their own story to embrace a larger understanding and better functioning, they must experience a perceptual shift about themselves and the world. To achieve this, they need sufficient personal and professional resources to be open to creating respectful doubt about their initial version of self and world, including other people. For the most part, these shifts are usually supported by family therapists utilizing only cognitive interventions.
Therapists, however, can also assist clients to access increased personal resources by using another language—the silent language of body-mind awareness. In the first place, thinking can only go so far without expanding consciousness to include the data of the functioning body-mind. Body awareness, and especially awareness of body sensations, bridges thought, action, and emotion, and assists ego functioning. Furthermore, it enables a client to contain them and digest many levels of stimulation and activation of the nervous system.
At the point where we left Bill and Ethel, I have these three phased outcomes in mind: increased awareness of their body sensations and experience; bridging between thought, action, and emotion; and utilizing that awareness to increase their sense of personal resourcefulness.
In Bill and Ethel’s case, after helping them to increase their body awareness, including calling up the abilities inherent in using a psychomotor developmental movement (Ethel’s standing on her own two feet, standing up for herself, and reaching out), I expect that both will be a little bit better able to reflect accurately and more flexibly on their experience in life. They are beginning to know themselves, to be themselves in a more “embodied” way. This embodied sense of self, as it develops, will increase their possibilities for being able to stay connected with each other, even when their opinions may differ. All too often, one person reacts unconsciously to maintain the stability of the “old” system, during family therapy or real-life changes. With the new resources they discover in their body-mind—the greater totality of themselves, their ability is enhanced to stand firm, to feel safe in their solidity in order to listen, to experience, and appropriately contain whatever troubling feelings, thoughts, or images that become stirred up by change and confrontation. With these new abilities, spouses can become genuinely curious about and attentive to the other person’s story.
This sort of body-mind work goes far beyond the body-language manuals, which define the meaning of this or that gesture and posture. What is involved is becoming aware of the body-mind continuum in its full presence and temporal dimension. A person, therapist, or client, is the embodied result of a lifetime’s development. Early developmental resignations or holding patterns can be tragically important in limiting personal adaptation and resourcefulness, thereby causing much of the pain with which patients come to us. Learning to see these can help the therapist, not only in assessment, but also in intervention choices. One must learn, for instance, how to differentiate between shock trauma and developmental trauma in choosing an intervention. Muscle tonicity responsiveness, movement patterns, knowing one’s way around the nervous system, and attention from a somatic perspective to how particular clients explain their worlds can be immensely useful.
When Bill comes in, he is stuck in his own story—that Ethel (and Tom) are “the problem.” My own view is that Ethel and Bill are not connecting in regard to the issue with Tom. My hypothesis—not unusual for a family therapist—is that their pattern of non-connecting has a lot to do with each of their family-of-origin themes and the intimacy, personal space, and comfort level each of them has individually about connectedness in general. But how can such themes and issues be approached most fully without attention to their embodiment, past and present, in each party? How they exist in relationship depends not only on their thoughts, values, and beliefs, but also their body awareness and their embodied character structure, who they have become over time, for better or worse, for quicker or slower, for full or empty, and so on. The fundamentals of this approach include body awareness (sensations—hot, cold, tight, loose, gravity, spatial awareness) and body-based associated experiences (emotions, memory, fantasy, images, thoughts). Clients and therapists need to learn how to observe and utilize these elements of the whole person. Each major aspect of that embodied self can serve as a powerful aid or a severe hindrance in helping the client resolve his problems by making new choices.
Over the next five sessions, we continued to work with body awareness related to their issues between each other, family-of-origin themes, and their attempts to reach some common agreement of what to do concerning Tom. During this time, we explored their views of what they each had (or had not) learned in their families-of-origin about connecting, despite differences, and how that might be affecting their own relationship, parenting style, and their relationship with Tom. Ethel talked about how it had been difficult to assert herself in her family. Instead, she had learned just to quietly resist doing what did not seem fair or right to her. Bill became more aware of how his deep concerns were so often expressed in anger and judgments, and how Ethel would then lose her sense of centeredness and grounding. Eventually, he discussed how his parents had broken up when he was only fourteen, and, when his father moved away to a distant city, he felt he had to be responsible for his mother’s household, and somehow had to take charge. As the therapist, I wondered how I could assist Bill to share the depth of this early loss with Ethel, in order to create some emotional common ground. He still spoke of his loss in the most hard-boiled and big-brave-boy manner. “That’s just how it was—life can be hard sometimes!” Before the ninth session, I decided to explore this theme once again.
When Bill and Ethel came into the room that day, I found myself vividly recalling earlier times when Bill looked more angry, and Ethel more collapsed. Though Bill still seemed over-contained to me, there was more lightness in his movements crossing the room, Ethel’s fragile-ness seemed to be fading away, and she also seemed more connected to herself and to the ground. After the usual greetings, I inquired about what had transpired since the last session. Ethel spoke first:
“We are doing better together and somehow, Tom is doing better too. He even went to a movie with us the other day. I’m not so frightened of Bill’s frustration, and know I’m stronger than I thought. I said to Bill the other day, ‘You have got to do something about your anger—what’s this all about?’ It came out of my mouth before I knew it!”
“What was that like for you, Ethel?”
“Surprising, but the most surprising thing is Bill just looked at me and said, ‘I don’t really know, this is just all too much!’ Then he walked out of the room. I didn’t know what to do after that. So I thought I’d like to talk about that here.”
“What do you think it was about?”
“Confusion, giving up, or something.”
“Bill, what was all that like for you?”
“Well she’s right—confusing. I just get frustrated and angry. I know we have talked about my sense of loss in my family and taking responsibly very early, but still this reaction all happens so fast—I don’t know exactly how to do anything differently.”
“What’s it’s like for you then that this happens?”
“Not good!”
“Want to explore it?”
“Yes!”
At this point, many schools of mind-body psychotherapy would work toward expression of the anger or, at the other polarity, encourage exploration of “mindfulness,” i.e., of Bill’s experience, his ability to be “non-attached” to his ongoing experience. In the approach I practice, that of Bodynamic Analysis, there is a third option. While at some time in the future it may be useful for Bill to experience his anger and cathart it, a couple’s session tends easily to an exaggeration of both emotional contents, and reaction to them. One can easily create more problems than one resolves. My assessment was that Bill had now developed sufficient cognitive and somatic consciousness to be able to reflect by himself, and make his own judgment of whether he is over-containing some of his emotions. In short, he is ready to explore this kind of material. Furthermore, he is beginning to wonder about how his present anger connects to his early losses. His story, his narrative about the reality around loss, hurt, and anger, is beginning to soften, and so, subtle body-mind awareness and trying on psychomotor patterns can be used. On the other hand, his resources to investigate body sensations and experience are still limited. He is not yet equipped for the best use of cathartic interventions, which include their attachment, in guided regression, to the original imprinting experiences. On the basis of Bill’s movement, body posture, and shape, as well as his perceptual framework and his anger, my characterlogical assessment is that he remains somewhat “stuck” in the will stage (2 to 4 years old). His concern with having to do everything on his own, distancing himself from help, implies even younger roots in autonomy issues (8 months to 2½ years). This kind of person, especially after only eight previous sessions, is hardly ready for such a deep plunge.
The use of anger as a defense against underlying feelings of helplessness and sadness, however, can be addressed now, in a powerful way, at the fourteen-year-old level—the level that Bill’s consciousness is already aware of.
“Bill, what happens when you think back about that time when you were fourteen—what particularly comes to mind?”
“Watching my dad packing and not knowing what to do—or say.”
“What happens in your body when you remember this?”
“My chest gets tight and I feel numb, like I don’t have any emotion. I’m stuck again.”
“What happens in your heart?”
“I can’t feel—it’s like I’m living on the surface of my body all over.”
“What’s that like for you?”
“Dead.”
“What would a dead heart say right now?”
“I’m dead—I won’t feel any more.”
With that, Bill’s chest takes a heave and his eyes fill with tears, then his shoulders seem to tighten.
“Bill, as an adult man now, what do you wish you could have said then to your dad?” (Bill’s chest begins to move in deeper spontaneous breaths.)
“Don’t leave me, don’t go away.” (Sobs come up and tears run down his cheeks.)
With that, Bill reaches out with his other hand, to hold on to Ethel, and his sadness emerges in hard, then soft bursts. By this time, Ethel is softly crying and my own eyes become quite wet as well!
Bill speaks: “Sometimes it’s just too hard to let you help, to feel I can hold on to you for strength. It’s hard to even know when I need help. In some ways you are much stronger than me.” (Ethel quietly responds by slightly nodding.)
“Bill, what does help look like?”
“Like this, just like this.”
“What happens in your body when ‘this’ happens?”
“I feel full inside and softer, my shoulders and back relax.”
“And your heart?”
“I can feel it, it’s not dead anymore.”
“What’s ‘it’ Bill?”
“My heart, my—my feelings—I can feel myself more, like I’m whole.”
“Ethel, what’s this like for you?”
“I guess I had still been thinking when we came in—that Bill didn’t need me in quite this way. Actually I feel more connected to myself and Bill right now. I feel like I’m in a precious state right now, seeing clearly into what it can be like for Bill underneath, rather than wondering if I’m a full partner in this relationship.”
“What happens in your body, right now?”
“I, too, feel softer and more connected in my whole body, and I wonder how we will not lose what we have discovered here.”
The session progressed with further movement toward connecting Bill’s sadness and his inability to ask for help, not knowing he needed help, and his prickly reactivity around his son’s acting out. In this and later sessions, he moved toward appreciating that at least his son was still “in there fighting” (even if it came out in resistance against him!), and that pushing on Tom would not help. Ethel came to understand that Bill’s anger had caused her to dig in her heels and distance herself from contact, which only aggravated both her and Bill’s sense of isolation. In ensuing sessions, they found new paths to revisit and explored many issues in their relationship where they had “lost their way.” They uncovered the sources of the early patterns in their families-of-origin, and the mind-body awareness (or lack of it) that was contributing to not understanding and connecting with each other. A central movement in the therapy process was visiting with their own parents and families, researching the family stories—their multigenerational histories. Patients who share this information with each other usually come to a new understanding of their heritage, and of their parents’ lives. As they found the edges of their own reactivity around these stories, we utilized both cognitive and somatic approaches to work through those impasses. This shift in thinking and felt reactivity helped them each understand themselves as well, and connect better with each other and other family members. Over time, they discovered that, even through the ups and downs of life, they could stay connected to themselves, and become less reactive and more able to listen and connect to one another’s struggles. Tom slowly settled down, and we did a couple of sessions with Bill, Ethel, and Tom together, mostly hearing from Tom about what his needs were in the family. Therapy ended when Tom managed to move to a school where he felt supported in “catching up” on the schooling he had missed. The whole process extended another twenty sessions.
In the past, practitioners of many body-mind approaches believed that therapy was a process of reducing or breaking down defenses—in somatic psychotherapy terms—“armor.” Some theory held that people are “armored” through their character structure from experiencing the deeper, more authentic self, the sense of vegetative (autonomic) flow, and their sensations of well-being. In the early mind-body theories of psychotherapy, character was originally defined as a fixed pattern of behavior, the way an individual typically handles his or her striving for pleasure. It is structured in the form of chronic and generally unconscious muscular tensions that block or limit impulses to reach out. Character was also thought to be a psychic attitude, buttressed by a system of denials, rationalizations, and projections, and geared to an ego ideal that affirms its value. The functional identity of psychic character and body structure (or muscular attitude) was then conceived to be the key to understanding personality, for it enables the therapist to read the character from the body, and to explain a bodily attitude by its psychic representations—and vice versa. In holding the premise that people only need to be released from the tensions of their character armor, however, earlier theory fell into an overly simplistic trap. Many contemporary somatic practitioners now believe the need to rethink this older theory, since the reduction or dissolution of an individual’s armor can disorganize a person’s whole system of adaptation and coping. When we, as therapists, intervene to remove some of this defensive armor, it is essential that other, more functional resources be found for the individual. In the instance of this case, our earlier work developing body awareness, maintaining an adult perspective in the intervention, and monitoring Bill’s connection with Ethel and myself as therapist, enabled him to maintain and improve the stability he needed to remain functional in the world.
When Wilhelm Reich, one of the founders of mind-body psychotherapy, developed this de-armoring process in pre-World War II Germany, people’s defenses were particularly strong. Today, our intent should be to help create better organization in a person’s psycho-physiological functioning, so that the person’s resources are developed and integratable over the long-term.
Properly worked with, body-mind approaches can facilitate very clear and functional connection with the person’s own wisdom, the inner knowing of how to manifest, in behavior, one’s very best intentions. It is very useful in that regard to understand early childhood developmental patterns, and the relationship between motor development and psychological development. A fine example of newer and more sophisticated approaches is the Bodynamics Analysis method, mentioned previously and developed by Lisbeth Marcher and her colleagues in Denmark over the last fifteen years, and now being taught internationally. This model is based on these psychomotor patterns and the work of Stern and Mahler, among others. It achieves its power through integrating new research on the psychomotor development of children with the knowledge of depth psychotherapy systems. This developmental approach allows for direct activation of undeveloped motor (body) skills and psychological (mind) resources.
Marcher took Reich’s idea that children frustrated in an activity may tense their muscles to hold back that activity. She realized that when the frustration of developmental activity is early or severe, the child may become resigned, and the corresponding muscles will be flaccid (under-responsive). When, on the other hand, response to the environment is appropriate, the muscles will have a neutral responsiveness tone, and the child will exhibit healthy actions to future situations. Since each developmental stage is comprised of specific sets of developmental psychomotor tasks, and since these tasks all have associated muscles, there can be any one of three overall outcomes for each stage: resigned (early frustration), held back or rigid (later frustration), or healthy (appropriate response). This information is then applied to the family-of-origin history and any “shock” trauma the person may have experienced, and used to explore various areas of ego functioning; i.e., grounding, centering, balance, boundaries, habits of interpersonal connection, and the like.
Typical of the new body-mind psychotherapies is a more sophisticated attitude toward touching the patient. The interventions with Ethel and Bill were made without my touching them. Much useful work can be accomplished without using touch, just by asking questions and directing the client’s attention. In the helping professions, there are many ethical and legal prohibitions against touch, and it goes without saying that the whole business of touch is a very sensitive topic, and appropriately so: “Fools rush in where angels fear to tread.” In my opinion, however, what the professions have done (due to unethical practitioners being justly confronted about their behavior) is taken too “safe” a route: no touch—no matter what the circumstances. Though touching is an exceedingly complex subject, requiring the greatest sensitivity, the highest moral standards, the deepest theoretical and practical psychotherapeutic training, and ethical professional supervision, many mind-body therapists, including myself, do utilize touch some of the time in their therapeutic interventions. The whole subject merits, again, our collective professional attention. A useful review of some of the research in this area has been made by Kertay and Reviere of Georgia State University1 and also by T. M. Field of the Touch Research Institute, University of Miami Medical School.2 In a less academic way, a wonderful caption about touch and connection was included in Life magazine,3 illustrating that lack of appropriate touch and connection can have profound implications for well-being.
In this short article, I have taken a single case to illustrate one mind-body approach, emphasizing somatic developmental psychology. By calling attention to some somatic principles, theory, and practice interventions as an aid to the family systems approach, I hope to stimulate some curiosity about mind-body modalities and lead some family therapist readers to explore reference materials and training in this area.
1. Kertay, L., & S.L. Reviere. “The Use of Touch In Psychotherapy: Theoretical and Ethical Considerations,” p. 47.
2. Field, T. M. Touch Research Institute, University of Miami’s Medical School.
3. Life Magazine, June 1996, featured a story regarding two premature sisters and the importance of touch and contact in sustaining health for one of them.
See also: Bernhardt, P., M. Bentzen, & J. Isaacs. (1996). “Waking the Body Ego, Bodynamic Analysis, and Lisbeth Marcher’s Somatic Developmental Psychology.” Energy & Character 27(1).