What is Somatic Psychotherapy?

By Dirk Marivoet, MSc., Registered Psychotherapist (ECP), CCEP, PMT, PT.

Body-centered or Somatic Psychotherapy (also “Body-oriented psychotherapy” or  “Body Psychotherapy”)  is a holistic form of psychotherapy which naturally incorporates the body within the psychotherapeutic process. It has a long history that can be dated back at least 120 years (through the legacy of Pierre Janet (1859-1947), one of the founding fathers of psychology and other influences go back even further. Body Psychotherapy uses various techniques which enhance the awareness of our body and through it, with our thoughts and emotions. It enhances personal growth and helps to overcome psychological weaknesses, symptoms and mental problems when present. The field of Body Psychotherapy has accumulated a lot of scientific knowledge and publications based on valid theoretical views.

The term “Body Psychotherapy” became well established in the larger field of Psychotherapy during the 1980s. The European Association for Body Psychotherapy (EABP), the scientific and administrative association for Body Psychotherapy in Europe, was founded in 1988. USABP is the organization active in the United States and was founded in 1996.

How does Body-Centered Psychotherapy work?

As in other forms of psychotherapy, the client works together with the psychotherapist to understand and therapeutically work through the issues s/he confronts. Together, they explore the client’s skills and talents that s/he can utilize and most importantly: they explore the client’s ability to heal themselves. They examine the way in which the client’s current problems might relate to their past life history, their experiences within their family environment and any major losses or traumas they had. They collaborate to discover what the client needs in order to deal with their current situation.

What is the advantage of working with the body in Psychotherapy?

There are many idiomatic expressions which indicate the somatic aspect of experience. For example, we refer to our ability to “take a stand”, to “be all ears”, to have a sense in our guts about something, to have an “open heart”, to “raise a wall,” “to blow their top,”etc.

In Body Psychotherapy these are not just metaphors. They are seen as the reality of our experience which manifests in our body. They are symbolic keys to crucial decisions we made for ourselves or ideas unconsciously passed to us through family or culture. For example, many people learned to withhold the expression of emotions which were forbidden in their family. Some have the tendency to collapse or withdraw or avoid challenges because they have been discouraged in the past.

We can for instance examine these body postures, patterns of tension or weakness, because they are linked to central issues of our existence and experiences. Working through all this helps us develop self-awareness and open the way for new modes of being. For example, a woman who was discouraged to speak within her family environment, might explore how she learned to clench her throat, shoulders and jaw in order to remain silent.  As she works through her emotions towards her family, she might learn how to bring more energy to the upper part of her body so as to have the strength to speak up for herself. In a similar way, a man who finds it hard to relax and allow himself to rest might explore how he forces his body to keep alert. He might then realize that he learned how to get into this alert state as a child, in order to avoid suffering from the lack of proper response to his needs (emotional/physical). This will enable him to consider new ways of being with himself and others.

A Focus on the functional relationship between body and mind.

The body psychotherapist focusses on the functional relationship and unity between mind and body. He takes into consideration the complexity of sections and interplay among them, with the common belief that the body reflects the whole personality.  “Body” in this context, does not identify with the pure physiological dimension, neither is there is a hierarchical relationship between the mind and the body. They are both functional and interdependent aspects of the whole human being. While other psychotherapy approaches hardly mention this perspective, Body Psychotherapy considers this fundamental.

Conceptual framework.

Body Psychotherapy includes a developmental model, a theory about personality, hypotheses about the roots of the pathogenic symptoms and dysfunctions together with a wide range of diagnostic and therapeutic techniques which are used within the context of the psychotherapeutic relationship. These techniques include the body through observing, touching and moving it and through breathing.

A science.

As a science, Body-centered Psychotherapy has been developing for more than seventy years, taking into consideration the research on biology, anthropology, the history of civilisations, neurophysiology, neuropsychology, developmental psychology, neonatology and perinatal studies along with the findings that come from the experience of its practice.

Body Psychotherapy is effective, as is shown by peer-reviewed research. Alexandra Bloch-Atefi and Julie Smith from Melbourne, Victoria, Australia have reviewed the literature which you can consult here http://pacja.org.au/?p=2552

An art.

Psychotherapy can also be called co-creative art (although it should be always based on science and knowledge). Therapists and clients can be seen as creating “healing cultures”. The way they do this is partly a mystery. Most likely, as in every art form, a certain talent, specific skills and life experience is required to be an effective body psychotherapist. The science of Body Psychotherapy is absolutely important, but is always complemented by a degree of craftsmanship and artistry.

Essential Concepts of Body Psychotherapy.

• Bodymind: Perhaps the most foundational concept of body psychotherapy, the bodymind represents the embodied integration of thoughts, feelings, and physical bodily experiences and sensations. All parts of a person can be accessed at various points in treatment in order to effectively and holistically address concerns. The „Bodymind” concept claims that our body is „living memory” and carries in it the signs and traces of our personal life experience as well as our familial heritage. All sorts of traumatic experiences and learned fears, impregnate our character and influence our posture which are tangible entrances to the whole Bodymind.
• Armoring and Character: Armoring is a concept developed by Wilhelm Reich, MD (24 March 1897 – 3 November 1957), a second generation psychoanalyst after Freud. He believed people developed systems of bodily “armor,” or muscle tension/rigidity, in order to protect themselves from emotional and physical pain. These sets of armor contribute to the development of a person’s “character,” according to Reich and his followers, who developed five basic character types to use during assessment and treatment.
• Energy: The concept of energy is central to the application of body psychotherapy. Energy metabolism, storage in and release from the body play an important role in how people carry themselves, hold themselves, experience and heal from pain, and interact with the world. Things like energy flow and release, pulsation, expansion and contraction (e.g. in tissues and organs), and energy charge and discharge are all things body psychotherapists pay attention to throughout treatment.
• Body Memory: This is the controversial premise that memories can actually be stored within the body. Body psychotherapists believe that because of this, some memories cannot be processed through talk therapy, but that these traumatic memories and problematic tension can often be released through bodywork and other physical techniques.
• Trauma: Body psychotherapy’s concept of trauma aligns with that of body memory, proposing that traumatic experiences can create energy build-up, or blockages, that lead to physical and mental health concerns.

Historical Development of Body-centered Psychotherapy.

It could be said that the history of Body Psychotherapy begins with the work of Pierre Janet (°1889), at least 3 years before Freud officially established psychoanalysis (1892). He coined concepts like “dissociation” and “subconscious”. According to David Boadella (1997), Janet placed an emphasis on the body of the patient and non-verbal communication. His findings are directly linked to Body Psychotherapy, since they include, among other things, significant information concerning the blocking of the diaphragm, the effects of emotional intensity on the flow of bodily fluids and the importance of manual work for patients who have undergone a traumatic shock.

► Another important researcher was Albert Abrams (1891–1910) from San Francisco, who based some of his theories on the work of Franz Anton Mesmer (1779) and Armand-Marie-Jacques de Chastenet and Marquis de Puységur (1784). He imagined that the secret to health and disease lie in the nature of vibrations emanating from the body’s cells as well as on the interrelation of mind and body.

►According to Boadella (1997), Freud conducted research on the findings of Janet and was influenced by his ideas, but later ignored the study of the body and focused solely on verbal communication. Initially Freud had described the idea of the ego as “first and foremost a body-ego” (Freud, 1923), stating the interconnectedness of mind and body. Also, he initially conceived of the libido within a framework of homeostasis promoting the liberation of bodily energy. Yet later he reconsidered, thinking that the body represents the dangerously predominant power of the instincts that should remain under the control of the mind. The mind thus became the focal point of classic psychotherapy as the means by which man can express his inner core after processing his thoughts and beliefs.

► It was finally Austro-Hungarian physician and psychoanalyst Wilhelm Reich (1897–1957), student and later collaborator of Freud, who gradually became the most important pioneer of Body Psychotherapy. Reich focused on the “Character” of the analysand – the special personal way of being – which forms the foundation for the symptoms that are exhibited. He introduced the concept of the “Armor” referring to the defence mechanism developed by a person in order to cope with intense sensory input and unbearable emotion. The Armor has a character aspect and a somatic aspect. Reich also developed “Neuro-vegetotherapy”, a method of restoring the health of the Autonomic Nervous System (ANS) through particular body techniques and exercises followed by verbal expression and processing.

Reich’s ideas on “Character” and the processing of resistance and negative transference were widely acclaimed by psychoanalysts, while his emphasis on working with the body, emotional discharge and sexuality was taken on and further developed by various neo-Reichian schools.
Later, Reich developed concepts like orgastic potency, sexual energy, and “orgone energy,” not embraced by established psychoanalysis.

► Other pioneers such as Georg Groddeck and Szandor Ferenczi experimented working in a more direct way with the body, while Alfred Adler, Carl Jung and other focused on how psychic energy is distributed throughout the body and on the relation between mind and body.
A few psychotherapists, contemporaries of Reich, were greatly influenced by his work with the body, in particular Fritz Perls (1969), founder of Gestalt therapy, Arthur Janov (1970) who founded Primal Therapy, and Stanislav Grof (1986) who named his own technique Holotropic Breathwork.

► Reich’s work on the body, muscular armoring and resistance, drew along many followers. In Norway and the United States, Reich worked with numerous therapists who incorporated his theory to their work processes. An international movement of Body Psychotherapy was developed, with quite a few variations either directly emanating from Reich’s work or adding substantially to it, or at least owing a lot to it.

► In the United States, Elsworth Baker, along with co-workers – known as “Orgonomists” – founded the American College of Orgonomy (1968) and published the Journal of Orgonomy, continuing the tradition of Reich’s Medical Orgonomy.
Second-generation Body Psychotherapists, trained by Reich in the United States and called “Neo-Reichians”, include Alexander Lowen, John Pierrakos, Myron Sharaf and Eva Reich.

► Physician Alexander Lowen (1910-2008) in collaboration with John Pierrakos, created Bioenergetic Analysis (1975), developing and adding very significant concepts-techniques to Body Psychotherapy: “grounding” in psychotherapy, standing up and deepening breathing.

► John Pierrakos (1921-2001), initially worked with Lowen, and then developed Core Energetics (1987) aiming to ease the release of the core self, combining his therapeutic experience in the practice of Bioenergetics with “The Pathwork” – the spiritual mediation used by his wife Eva Pierrakos – with the focus on love as man’s deepest truth.

► Eva Reich, W. Reich’s youngest daughter, developed the technique of Gentle Bioenergetics or Butterfly Baby Massage (1996), a kind of soft massage that can be administered by mothers to babies born prematurely in order to aid the process of establishing a relationship that has been disrupted.

► In Norway, psychoanalyst Ola Raknes (1887-1975) was also trained by Reich in Characteranalytic Vegetotherapy and later he himself trained other therapists such as A.S. Neill, Paul Ritter, Peter Jones, David Boadella, Gerda Boyesen and Malcolm Brown. A few of them developed their own view of Body Psychotherapy and formed the third generation of Body Psychotherapists.

► Thus, David Boadella developed Biosynthesis, delving on how the three embryological layers – endoderm, mesoderm and ectoderm – influence the body’s current structure. Boadella was a very significant personality in the area of Body Psychotherapy, especially from 1970 to 1990. He founded the first journal on the subject of Body Psychotherapy, titled Energy & Character, with the help of which Body Psychotherapy acquired consistency and an independent identity as a scientific discipline. In addition, he was a founding member of the European Association of Body Psychotherapy (1988) and its first president.

► Gerda Boyesen (1922-2005) founded Biodynamic Psychology (1980), contributing the understanding that the self-regulation system of emotional intensity functions not only through the orgasm reflex or the relaxation of muscular armour, but also based on the parasympathetic activity in the digestive system. She introduced the terms “emotional absorption” and “psychoperistalsis”, and developed theory and techniques for the relaxation of the armour at the connective tissue and muscles according to Reich. She also developed a kind of very subtle massage relaxing and rebalancing the ANS, thus enhancing the expression of emotion lying behind the bodily tension.
Her son, Paul Boyesen, later created his own method, which he called Psycho-organic Analysis.

► Malcolm Brown and his wife Katherine Ennis Brown, influenced by the Gestalt psychotherapy and by Charlotte Selver, Carl Rogers (2003), Reich, Lowen, Boadella (1987) and Boyesen (1980), developed Organismic Psychotherapy. They delved into the effect created by the therapist’s touch and how it differentiates when the therapist is a man or a woman. Malcolm Brown conducted research into the varying functionality, in therapy, of “vertical grounding” (standing position) compared to “horizontal grounding”.

► Lillemore Johnsen (1981), influenced by Freud and Reich, and through a more existential point of view, developed a particular method of “reading the body” through soft touching and restoration of breathing, with precise diagnosis. She called her modality Integrated Respiration Therapy.

► Lisbeth Marcher (1989), using some of Johnsen’s ideas, created the Bodynamics modality which states that personality problems and the elements of character structuring result from conflicts in relationships. Her techniques aim to transform old and persistent behavior motifs through the education process and the energizing of kinetic and psychological resources.

► Charles Kelley (1922-2005), a direct student of Reich, created the Radix method (1970s), a kind of “training in emotion, purpose and improving eyesight,” combining the techniques of Reich on emotional discharge and the method of William Bates for the improvement of eyesight.

► Stanley Keleman (1986), a student of Alexander Lowen and Ola Raknes, differentiated greatly from Reich, proving that the concept of muscular armor, energy flow and its restriction is extended not only to muscles but also to the body’s soft tissue, the bowels. He calls his approach Formative Psychology and studies the relationship between emotions and anatomical form (Emotional Anatomy).

► Ron Kurtz (1990), combining the influence of Gestalt therapy, Arthur Janov’s Primal Therapy, Rolfing, Bioenergetic Analysis and the work of John Pierrakos, Al Pesso and Moshe Feldenkrais, developed the Hakomi method that helps a person realize what he has the potential to become or what he should become.

► Jack Lee Rosenberg (1996) created Integrative Body Psychotherapy encapsulating features from yoga, Bioenergetic Analysis, Reichian analysis, psychoanalysis, Transactional Analysis and object-oriented relationships.

► Psychiatrist Jerome Liss (1986) developed Biosystemic psychotherapy, which combines various ways of working with the body, in order to explore the relationship between the parasympathetic and the sympathetic system of the ANS. The resulting emotional deepening helps a person restore a healthy balance.

► In the next generation of Body Psychotherapists who had no contact with co-workers and students of Reich, Jacob “Jay” Stattman (1989 and 1991) founded Unitive Psychology, unifying elements of Humanistic Psychology with the theoretical work of Reich and some psychodynamic elements of Character Analysis. He used various techniques on the body, focusing on breathing, movement and contact, influenced by Gerda Boyesen, Reich, Lowen and Feldenkrais.

► Influenced by Gestalt therapy and Bioenergetics, psychiatrist Yvonne Maurer (1993) developed Körperzentrierte Psychotherapie (IKP) (Body-centered Psychotherapy).

► Luciano Rispoli (2008) developed Functional Psychotherapy, exploring the functionality of a person on all levels: mind, emotion, body, physiology. Therapy aims to mobilize and again incorporate the altered functions so as to restore primal fundamental experiences.

► Arnold Mindell, initially a Jungian analyst, at the late 1970s developed his own modality of Process-oriented Psychotherapy, which follows the psychological workings of a person during his development and movement through various channels.

► Another main stream within Body Psychotherapy is Dance-Movement Psychotherapy, a somatic psychotherapeutic version of the Dance-Movement Therapy that grew out of the work by Elsa Gindler, Marion Chase, Isadora Duncan, Martha Graham, Doris Humphrey and others.

► Ilana Rubenfeld (1998) developed the Rubenfeld Synergy Method (RSM), using a kind of touch with the hands, quite similar to Gerda Boyesen’s technique of mild biodynamic massage.

► Jack Painter’s  Bodymind Integration (also PsychoCorporal Integration) combines body psychotherapeutic methods with specialized forms of deep holistic bodywork. There are three forms of PsychoCorporal (Bodymind) Integration : Postural Integration® (which in it’s psychotherapeutic form (PPI) is accredited by EABP and EAP), was developed in the 1960s (See: Deep Bodywork and Personal Development, 1987) as an original synthesis – not an eclectic combination – of Reichian Therapy (Rafael Estrada Villa, Peter Levine), Gestalt Process Work (Marty Fromm and Fritz Perls), Rolfing (Ida Rolf & Bill Williams), Psychodrama, Movement Awareness and the theory of the 5-elements. Later -in the 1980s and 1990s – Energetic Integration® and Pelvic-Heart Integration® were developed and are taught as separate modalities in 3 to 4 year programs. 

►There are also some people who dealt with a kind of “somatic therapy” to which they proceeded to add psychotherapeutic features so as to transform it to Body Psychotherapy. For example, in the United States, Susan Aposhyan (2004) transformed Bonnie Bainbridge Cohen’s Body-Mind Centering to a form of Body Psychotherapy. Albert Pesso and his wife Diane Boyden-Pesso (1961), who started out as professional dancers, studied the way that movement can ease the expression of emotion. In this way, they developed the Pesso-Boyden System of Psychomotor Therapy (PBSP), which involves a rich form of structured body-oriented psychodrama. The important work of Hilarion Petzold, founder of integrative movement therapy (Integrative Bewegungstherapie) and the Fritz Perls Institut in Germany also needs to be mentioned. Like Pesso, he was and is of great influence to Psychomotorische Therapie (psychomotor therapy), an established treatment method in mental health care thaught at University level in Belgium and the Netherlands.

Although body psychotherapy has common places with some body therapies, body techniques and complementary branches of medicine that refer to the body, it is very different on the aspect of being a psychological therapy. Body Psychotherapy has been scientifically established by the EAP (European Association for Psychotherapy) and the professional qualifications which are required for its practice have also been scientifically defined. Finally, there are a lot of different and sometimes differentiated enough approaches within Body Psychotherapy, as is also the case in other branches of psychotherapy.