Origin of body-oriented psychotherapies

Generally, the beginning of the line of psychotherapies working directly on the body is traced back to the work of Wilhelm Reich in the first half of the twentieth century. Reich, a pupil of Freud, in front of the rigid resistance by some patients who closed themselves without speaking, sensed that, by touching the body, there was the possibility of overcoming these blocks. He then developed a comprehensive theoretical model focusing on the muscle and energetic block in the body, a consequence of the traumas and negative stimuli suffered by the person. Along this line, he set his therapeutic work, based also on the contact with his patients' body. There are now schools following Reich’s method in many countries.

Spread

This therapy modality then spread declining in various forms; here we recall the best known:

• bioenergetic analysis (see www.siab-online.net; www.biosofia.it) (vd. www.siab-online.net; www.biosofia.it; iifab.org)
• organismic psychotherapy (see www.psicoterapiaorganismica.it) (vd. www.psicoterapiaorganismica.it)
• Reichian analysis (see www.analysis-reichiana.it) (vd. www.analisi-reichiana.it)
• biosystemic psychotherapy (see www.biosistemica.net) (vd. www.biosistemica.net)
  
  

All these schools have in common a bottom-up approach to clinical work: they start from the bottom, that is, from the body, to reach the top, i.e. speaking. They therefore differ from all top-down approaches which, instead, start from the speech. With this in mind, we understand that there is a wide range in the world of psychotherapeutic counselling. We therefore go from therapeutic professionals who in no case touch the patient’s body to others who make the contact dimension their main work plan, passing through many who integrate various approaches and techniques. It is possible to easily meet psychotherapists who work on the body in all Western countries - their number is progressively increasing also thanks to neuroscience confirming over and over again the goodness of these models and due to a tendential rise in the request for psychological help in our societies. Furthermore, there is the feeling that the integration of the ‘body’ in the healing process is being welcomed by more and more people.

Peculiarities

In short, the main peculiarities of body-oriented psychotherapies are as follows:

• attention paid to non-verbal aspects (expression, colour, appearance, resonances with the therapist's body)
• attention to the distribution of energy in the body
• attention to the quality, structure and rhythm of breathing
• attention to blocks, stiffness and muscle contractures
• attention to physical and psychosomatic symptoms

The body psychotherapist pays particular attention to non-verbal aspects: posture, appearance in general, gestures, tone of voice and skin, quality of eyes, etc. because they believe, as the title of the book by Luciano Marchino says, ‘the body does not lie’ (Il corpo non mente by L. Marchino Italian ed. by Sperling & Kupfer) and therefore one can receive from the body quite significant messages.Il corpo non mente di L. Marchino ed. Sperling & Kupfer) e che quindi, dal corpo, si possono ricevere messaggi significativi.

By observing the patient, one can understand which traits need more work: some need to be able to express their repressed anger, others need a slight contact that transmits warmth and support, or both. And much more, of course.

A blocked or contracted breathing in different parts of the body (throat, chest, belly, pelvis) is always linked to previous traumatic and uncomfortable states that still affect the present time. This too is an important element for understanding the structure of the person in front of you and for setting up a therapy.

Through observation and contact it is possible to perceive muscle contractures and decide how to act for their progressive dissolution, in more or less gentle ways. All this always with great delicacy and carefully recording the feedback reactions that the work triggers in the patient.

Listening to the clinical history (previous diseases and disorders) and to any problems that are supposed to be related to the mind gives the psychotherapist very useful information to get to know the patient and to be able to work with them in the best way. If it is true that much of us is linked to our history, we must also insert the body into that ‘us’.

Body techniques and exercises

There are many ways in which a therapist can work on the patient's body and each one has their own style that has been created over time based on one's own training and clinical practice – through which they can identify the methods they consider most effective and which they prefer to operate with.

We can identify some macro areas:

• guided meditations and visualizations: the patient, usually lying down or comfortably seated, is invited to a deep relaxation. The transition from thoughts to bodily sensations is stimulated. What is happening in my body now? What do I feel? Without any judgment or evaluation. You just focus on what is there. Sometimes it is possible to propose images which the patient's imagination may hook into, giving them a personal shape. These works help to relax breathing, to develop creativity by moving away from negative thoughts and to enter pleasant states of relaxation and peace. But, also, to perceive without shortcuts our limits and the parts of ourselves that we find hard to accept. These are processes that require a long training to be sufficiently mastered by those who carry them out, also because they constitute a dimension that was initially unknown.
• body expressiveness exercises: it often happens that people have excessively inhibited their aggression by concretely blocking it in their body and this is harmful to their well-being, since it turns into a depressive condition (where the alternation between sympathetic and parasympathetic systems does not works properly) and/or triggers psychosomatic disorders (indigestion, ulcers, shortness of breath, chronic fatigue, insomnia). You can then propose the patient to beat their fists against a pillow and say a ‘no’ out loud or to beat a tennis racket against a mattress; to squeeze a towel; to push the therapist's body away with their arms or legs. Voicing or screaming can loosen a blocked throat, re-accustoming people to saying all those noes they haven't allowed themselves to say for a long time. All this should always take place in the protected therapeutic setting and without forcing the hand if the patient does not feel ready.
• catalytic and nutritional contact: this method, which is usually applied to the patient lying on the mattress, particularly facilitates regressive dimensions and body awareness. The catalytic contact is more energetic and through a stimulation with the fingers it loosens particularly contracted muscles; the nutritional one is sweeter and slower: the clinician gently places his or her hands on parts of the patient's body (hands, feet, head) and remains there for a few minutes. This technique nourishes ancient needs for safety and body nourishment that have been lacking in the past, giving people a sense of protection, warmth and deep awareness, generating internal reorganization processes that are not always easy to go through, but which will then increase one’s well-being.

It must be said, to conclude, that these methods, to be fully understood, should be experienced directly on oneself: using words to describe the sensations that may be generated with this type of work can be limiting. However, this brief summary can at least help to understand what one is talking about when they say body-oriented psychotherapy, given that sometimes people approach psychotherapy knowing very little about it, perhaps only with the classic and stereotyped image of the psychoanalytic couch. In reality, the branches of clinical psychotherapy are several, with very different approaches and histories. This is one of them.

Nicola Bonacini