8. Please provide evidence that your approach is open to dialogue with other psychotherapy modalities about its field of theory and practice.

 

Body Psychotherapy has always been open to dialogue with other psychotherapy modalities. Many Body Psychotherapists have had training in other modalities and many of the developments in Body Psychotherapy have utilised and integrated aspects from other psychotherapies.

Wilhelm Reich was a major trainer of Freud's before he created his form of Body Psychotherapy. Freud wrote letters encouraging Reich to write his first version of character analysis. Some of Reich's psycho-analytical research had a lasting influence on psychoanalytical history (1) & (2). Reich was also one of the trainers of Franz Alexander who was one of the creators of psychoanalytic psychosomatic therapy, and of Fritz Perls who latter participated in the creation of Gestalt therapy. Thus, from the very beginning, Body Psychotherapy was in intense interaction with the history of psychotherapy. During the persecutions from Macarthyism, Body Psychotherapists contracted their public image until the 1970s. But when it opened up again, it was with the support of general social trends, and in interaction with ongoing research which increasingly supporting the notion that models of human psychopathology should involve bodily phenomena. The psychoanalytic research on 'bonding' by Spitz and Bowlby (among others) influenced Body Psychotherapy of that period, as well as other Humanistic Psychotherapies (Gestalt, Rodgerian, Transactional Analysis, etc.) and also some systemic psychotherapies. With the development of psychotropic drugs, psycho-physiological research not only influenced Body Psychotherapists deeply, but also gave them more sophisticated tools, rather than the primitive energy concepts many were using before.

Many modern Body Psychotherapy schools are the product of interactions between Reichian Body Psychotherapy and other schools. An increasing number of Body Psychotherapists have an academic training which is thus integrated into their field of awareness and practice. Alexander Lowen created Bioenergetic Analysis as a proposed synthesis between Reichian techniques and Hartman's ego psychoanalysis (see Appendix 7); George Downing has always worked with psychoanalytic and systemic concepts; Gerda Boyesen incorporates biochemistry and physiotherapy; Hakomi has similarly a wide perspective (see Appendix 8 and Appendix 15); and Pesso Boyden System Psychomotor draws on psychodrama and Gestalt heavily in it's system of referring to the body (see Appendix 31).

Many Body Psychotherapists have had training in other modalities and many of the developments in Body Psychotherapy have utilised and integrated aspects from other psychotherapies. Some of the major structural and political developments within EAP have been sponsored by people representing Body Psychotherapies working in close harmony with other modalities, and specific examples of this is the formation of the European Wide Organisations Committee (EWOC) and the presentation about Body Psychotherapy at the 1997 Rome EAP Congress. This is not just because of the vocality and predilicitions of the representatives of Body Psychotherapy, but can be indicative of a wideness of theory and a freedom of practice as compared to some other psychotherapies.

There are also many intercollegial contacts within the different Body Psychotherapies. At present the most significant movement in this direction in Europe is The FORUM for Body Psychotherapy Organisations, sponsored by EABP (see Appendix 13). EABP has also run a significant number of conferences which demonstrate this point with respect to other modalities within the field of psychotherapy. (see Appendix 11 ) The most significant of these was the 5th EABP Congress on Body Psychotherapy in Carry-le-Rouet, France in April 1995 and was entitled Six Perspectives on Body-Psychotherapy. This had major presenters from the fields of Psychoanalysis, Jungian Analysis, Gestalt Psychotherapy, Spiritual Psychotherapy, Psycho-Neurological, and Biosystemic. The presenters were Anne Fraisse, Carl Lucas, Serge Ginger, David Boadella, Tilman Moser, Luciano Rispoli, and Jerome Liss and their articles were translated into the main European languages (English, French, German, Italian & Spanish). However EABP has also been a significant influence on the American scene and help initiate the founding of the US Association for Body Psychotherapy (USABP) and is collaborating with them on the founding of a new international scientific journal for Body Psychotherapy (Appendix 36).

Specific Body Psychotherapies, like Bioenergetic Analysis, have, for many years, looked at integrating aspects of their particular form of Body Psychotherapy with other psychotherapies and other disciplines (see Appendix 7). Hakomi has similarly a wide perspective (see Appendix 8). So has Pesso Boyen System Psychomotor (see Appendix 5 and Appendix 31) and Rubenfeld Synergy (Appendix 32). This is also true for many other Body Psychotherapies. Body Psychotherapies, such as Biosynthesis and Psycho-Organic Analysis have already answered this aspect satisfactorily in their submissions about Scientific Validation to the EAP. Not all Body Psychotherapies are fully represented in the EABP, but reviewing the respective bibliographies in school publications constantly illustrate the depth and the richness of the connections between Body Psychotherapy schools and other forms of knowledge. Numerous examples of our literature can be found in the bibliography at the end of this paper.

Jerome Liss also writes in much more detail and at some length about this integration between Body Psychotherapy and other types of psychotherapy (see Appendix 23 ).

References:
(1) Kernberg O.:Severe Personality Disorders. New Haven: Yale University Press, 1998.
(2) Sterba R.F.: Clinical and therapeutic aspects of character resistance. In Bergman M.S. & Hartman F.R. (ed.) 1976: The Evolution of Psychoanalytic Technique. New York: Basic Books Inc. 1953/1976.

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9. Please provide evidence that your approach has a way of methodically describing the chosen fields of study and the methods of treatment or intervention which can be used by other colleagues.

 

Body-Psychotherapy has, as mentioned, many methodologies and nearly every one of these focusses on a different aspect of the bodily structures and how they relate to the person's psychology (and visa versa) and, as a result, has a chosen area of study. This, in turn, gives a method of treatment. These methods of treatment have been described in various ways and many are identified herein. However the methods of Body Psychotherapy can only be used efficiently and effectively after several years of training. The sharper a scalpel is in the hands of a competent surgeon, the more useful it is and the more dangerous when used by others.

Some exercises used in Body Psychotherapy can be helpfully used at home and are described in various exercise books published by Alexander Lowen (1) and Jack Lee Rosenberg (2), for example. Rubenfeld Synergy uses extensively exercises drawn from Feldenkrais' "Awareness through Movement" work. Other books by Lowen (3) & Rosenberg (4) describe in a more general way specific modes of intervention for a fairly wide public. But even those exercises can be used in different ways, with various degrees of efficiency. An example of various possibilities is described in detail in Heller (5).

A detailed description of Body Psychotherapy techniques cannot comprehensively be published a) because it might encourage uncontrolled use of these methods, and b) because they do require a form of know-how which cannot be adequately describe by writing and which needs to be experienced and refined as in training sessions. As in many psychotherapies, the practice of Body Psychotherapy is nor scientific but more craftlike, complex, artful, partly intuitive, and the whole is not easily reduced to the sum of it's parts for purposes of measurement.

Those that want more detailed knowledge may have access to video demonstrations. They can perhaps attend introductory workshops provided by many schools of Body Psychotherapy, become patients for a short term or long term Body Psychotherapy, or follow an established Body Psychotherapy training course. In all these modes of exposition of our knowledge, persons may contact our methods in a way where an exercise is shown in a relevant theoretical context and know how, which also takes into account the potential benefits of each, and the contra-indications of each method.

There exists no published manual through which a person could gather in depth practical knowledge without proper training. However many authors (some of which have just been named), provide in depth description of the kind of techniques that are used, the principles used, the theoretical background, prescriptions, and case analysis. Many of the training centres have written manuals that encourage consistency in trainees. The Training Standards and The FORUM accreditation process requires that training schools try to ensure such consistency and quality in their trainees and also that their trainers and supervisors are experienced and up-to-date.

The models of character analysis initially proposed by Lowen (3), Baker (6), and Reich (7) were constructed to guide therapists, so that they only use adequate and differentiated approaches relevant for each type of patient. Through the immense literature published by Body Psychotherapists allows critical discussions of our work by other branches of psychotherapy, as in the discussion of Reich's work in Bergmann and Hartman (8). More recently a book edited by José Guimün (9) attempts to assess a specific approach (the Ajuriaguerra Psychomotor Therapy) associating experimental research and a clinical evaluation from several modalities.

Jerome Liss proposes a series of methods that can be used by all Body Psychotherapists in various ways (Appendix 22). Knowledge on different schools can also be found on various websites. Bioenergetic Analysis describes on their website their particular area of study and methods of treatment and interventions (Appendix 14). Hakomi Body Psychotherapy has a different area of study and different methods and ways of working. These are more extensively described on their website, with examples from a sample session. (Appendix 15). The Pesso Borden System Psychomotor also has a website and a session is described (Appendix 31).

Biosynthesis has yet a different set of study fields and utilises the study of embryological layers (for example) to help understand the client's processes better. These and the methods that derive from them are very clearly described in David Boadella's book "Lifestreams" (10), and this forms a sort of basic manual to the method.

Other Body Psychotherapies all describe their chosen fields of study and the methods of treatment / intervention which can be used by others and can be systematically taught to trainees. We append a draft of a new Training Outline for the Gerda Boyesen Centre for Biodynamic Psychology and Psychotherapy, London, Britain (Appendix 16) as an example of this in this particular method. There are also the Collected Papers of Biodynamic Psychology (11) that reinforces this. In other disciplines, the Character Structure Development Model of Biodynamic is another example of a theory pointing out fields of observation and connected methods of intervention (see Peter Bernhardt et al.: Waking The Body Ego Part I and II,1997 in Question 3 and also Appendix 30).  The evolution of Jay Stattman's Unitive Body-Psychotherapy is also generally explained and its methodologies are presented fairly clearly and informatively in the Collected Papers, edited by Güstl Marlock (12).

References:
(1)
Lowen A.: Bioenergetics. New York: Coward, Mc Cann & Georghegan, Inc., 1975:
(2) Rosenberg J.L.: Total Orgasm. Berkeley: Random House, 1973.
(3) Lowen A.: The Language of the Body. New York: Collier Books, 1958 / 1973.
(4) Rosenberg J.L., Rand M., Asay D.: Body, Self and Soul. Atlanta: Humanics, 1985.
(5) Heller M.: The Jelly Fish (Part II). Energy and Character, vol 25, n.2, April 1994, pp. 18 - 43.
(6) Baker E. F.: The Man in the Trap. New York: Avon Books, 1967 / 1974.
(7) Reich, Wilhelm: Character Analysis, Farrar Straus & Giroux, New York, 1972 (3rd ed.)
(8) Bergmann M.S. and Hartman F.R.: The Evolution of Psychoanalytic Technique. New York: Basic Books, Inc. Publishers, 1976.
(9) Guimün J.: The Body in Psychotherapy. Basel: Karger, 1997.
(10) Boadella, David: Lifestreams, Routledge & Kegan, Paul, 1987.
(11) Boyesen, Gerda & Mona-Lisa, et al., The Collected Papers of Biodynamic Psychology, Vol 1 & 2, 1980, Biodynamic Psychology Publications
(12) Stattman Jacob et al., Unitive Body-Psychotherapy Collected Papers, Vol 1 (1989) & 2, (1991), Afra Verlag.

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10. Please provide evidence that your approach is associated with information which is the result of conscious self reflection, and critical reflection by other professionals within the approach.

 

The members of the EABP represent many facets of existing psychotherapies including the bodily dimension in their work, so that our association is used to frame rich discussions on the topics that unite us. Many participate in various Congresses and common publications (e.g. Boadella (2), Caldwell (3)) in which several schools of thought express themselves in what can be regarded as conscious forms of communication (presentations, publications workshops, video's, supervision, inter-vision, and other forms of socialised or conscious communication). Furthermore most pupils in schools have an academic or professional training elsewhere, and are usually capable of formulating a critical evaluation of what they are learning in an open and conscious form of communication.

The Bibliography joined with this report, and the EABP list of Congresses can be taken as evidence that the EABP encourages "critical reflection by other professionals within the approach". Most schools that are part of the EABP similarly organise Congresses, have a bibliography, sometimes publish rigorous journals (mentioned in detail elsewhere), propose workshops, and could provide similar forms of evidence if required.

Examples of critical discussion on Body Psychotherapy are the following:

- A critic of the reichain energy concept can be found in Downing (5), Geissler (6), Mann (12), Heller (8), Stupiggia (16).

- We are aware that there exists other ways of approaching the relations between body and psychotherapy, as discussed in De Ajuriaguerra (3), Jacobs (11), Guimén 1997, Roux & Déchaud-Ferbus (14) & (15).

- A critic on ethics related to the management of transference in Body Psychotherapy can be found in Heller (7), Hunter & Struve (10).

- An epystemological critic attempting to describe what type of knowledge is particular to body psychotherapy can be found in Rispoli (13), Heller (9).

- Jerome Liss looks in depth at Systemic Interactional Theory as opposed to theories of linear thinking and has applied this very significantly to Body Psychotherapy. He uses Carl Hempel's scientific model as support for this. (Appendix 21)

Body Psychotherapy is - by the definition of psychotherapy defended in the EABP - a process oriented therapy, involving consciousness. Thus using medication or body techniques which influence moods are not enough to constitute what we call psychotherapy. They may on the other hand be a method used in psychotherapy, which necessarily involves conscious awareness, insight, and symbolic integration through movement, vocalisations, and linguistic formulations (verbal and written).

Conscious self reflection is part and parcel of the paradigm of Body Psychotherapy. A consistent underpinning of the various forms of the work involves regaining, reinforcing and utilising conscious contact with the body - the proprioceptive sense. Conscious self-reflection is absolutely necessary to renew and maintain this contact. This is often what attracts clients to Body Psychotherapy and is thus part of the Body Psychotherapist's task and therefore exists as a pragmatic priority in the client-therapist relationship.

This conscious self reflection is mirrored in the theoretical development of Body Psychotherapy. The growing body of literature in the field, some included in the EABP Bibliography and much found in the several rigorous journals (mentioned in detail elsewhere) attests to the longevity, breadth and depth of such conscious self reflection that has been the foundation of Body Psychotherapy theory.

One of the editors of these journals, David Boadella (Energy & Character), developed his neo-Reichian work in exactly this manner. As a result of his being influenced from so many other sources over the years, he built-up his own way of working into a reputable body of knowledge that he now calls "Biosynthesis". This form of Body Psychotherapy has already been accepted by the EAP as being scientifically valid, and it has also been accepted by the Swiss Psychotherapy Charta; and as a Weiterbildung in Austria and as a form of depth-psychological psychotherapy in Germany.

As regards the "critical reflection" aspect of the Question, Jerome Liss looks in depth at Systemic Interactional Theory as opposed to theories of linear thinking and has applied this very significantly to Body Psychotherapy. He uses Carl Hempel's scientific model as support for this (Appendix 21). There are also many other similar examples mentioned in this submission.

As previously mentioned, the immense literature published by Body Psychotherapists allows critical discussions of our work by other branches of psychotherapy as well as from those within the field. The frequent, lively.discussions, arguments and presentations at the Body Psychotherapy congresses further allows for critical evaluation and reflection within the field. These congresses have become international talking place in Americas as well as in Europe. There are presentations from leading research Body psychotherapists and scientists as well as theoreticians and practitioners. One such Congress is the EABP Congress in Travemünde, Germany in September 1999 (Appendix 37).

In November 1997 there was a meeting of 600 experts on psychotherapy in Bern, organised by the OFAS, representing the Swiss government on health matters. Dr Mattanza wrote a report for the OFAS named (translated): "Criteria which could allow to evaluate the efficiency, relevance, and the economical caricature of methods of psychotherapy".

In his speech Dr. Mattanza stressed that such an evaluation could not be based on experimental research only. In his conclusion, he also stressed the following points:

1. We should already take into account the existing literature, which shows that at least some psychotherapies are efficient.
2. That one needs further evaluation before one can find methods to validate the range of psychotherapeutic methods.

A commission of 8 main experts also spoke. Three of these (Prof. Grawe, D. Orlinski and H. Strupp) where very severe with Dr. Mattanza's position on the difficulty of evaluation psychotherapy through research. The other 5 experts were more moderate, for different reasons. Although they all stressed the need for empirical experimental research, they however clearly showed the limits of this procedure in terms of truth and use (1).

References:
(1) This is based on an article of professor Nicolas Duruz (Evaluation des Psychothérapies), published in the journal of the Swiss Federation of Psychologists (Psycoscope, n. 5, vol. 19, 1998, pp 19 - 21).
(2) Boadella D.: In the Wake of Reich.London: Coventure, 1976.
(3) Caldwell C.: Getting in Touch. Wheaton: Quest Books, 1997.
(4) De Ajuriaguerra J.: Le Corps comme Relation. Revue Suisse de Psychologie, vol. 21, 1962. pp.137-157.
(5) Downing G.: Körper und Wort in der Psychotherapie. München: Küsel, 1996.
(6) Geissler, P.: Neue Entwiclungen in der Bioenergetischen Analyse. Berlin: Peter Lang, 1997.
(7) Heller M., 1989: Deflux et Contre-Transfert. Adire n.4, pp 99 - 132
(8) Heller M.: The jellyfish, part I. Energy and Character, vol 24, n.2, 1993. pp 1 -27.
(9) Heller M.: Pour une Ethique de la Connaissance en Psychothérapie. Adire n.4, 1993 pp 29 - 62
(10) Hunter M., Struve J.: The Ethical Use of Touch in Psychotherapy. Thousand Oaks: Sage, 1997.
(11) Jacobs T.J.: Nonverbal Communications. Journal of the American Psychoanalytic Association, vol. 42, n.3, 1994. pp 741 - 762.
(12) Mann E.W.: Orgone, Reich, & Eros. New York: Simon and Schuster, 1973.
(13) Rispoli L.: Psychologia funzionale del SÈ. Roma: Astrolabio, 1993.
(14) Roux M.-L., Déchaud-Ferbus M.: Le Corps dans la Psyché. Paris: L'Harmattan, 1993.
(15) Déchaud-Ferbus M., Roux M.-L., Sacco F.: Les Destins du Corps. Toulouse: Erös, 1994.
(16) Stupiggia M.: Introduction. In Liss J., Stupiggia M. (ed.), 1996: La thérapie biosystémique. Paris, 1996: Hommes et Perspective, pp 11 - 27.

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11. Please provide evidence that your approach offers new knowledge, which is differentiated and distinctive, in the domain of psychotherapy.

 

The knowledge that we offer the domain of psychotherapy is (as has been described) differentiated and distinctive in that we, more than any other branch of psychotherapy, deal with the direct link with and the interactions between the mind and the body. Most other psychotherapies (mainstreams or modalities) do not have this as a major feature of their work. There are studies within cognitive-behavioural psychotherapy and within the field of psychology about various aspects of psychosomatics, physical reactions to certain stimulae, etc. but these tend to be peripheral to their main body of work. Even in the work of Rossi which stems from Ericksonian hypnotherapy and takes into account the effect of hypnotic phenomena on somatic symptoms, the focus is primarily on cognitive processes and little attention appears to be paid to the body except as it is affected by mental activity.

In contrast, work from Bioenergetics (some of which has already been mentioned) that is particularly different, separate and distinctive, has been Alexander Lowen's development of neurotic character structures and methods of dealing with it in "Language of the Body" and other books; and his preventative exercises in "A Way to Vibrant Health". Lowen also worked a lot on the importance of bodily posture and stance. Some of this field has been added to more recently in areas of Body Psychotherapy like Postural Integration.

In Biodynamic Psychology, the central aspect of Gerda Boyesen's early work was the relationship between the autonomic nervous system, emotions, and the activity of the intestine as a digester of emotions and a regulator of emotional health. Her psychotherapeutic massage and physical work led directly to new insights in psychotherapy and a gentler application of other psychotherapeutic techniques. David Boadella has developed some of this detailed physiological work and has written about the effect of working on different embryonic layers; muscle tone and resting potentials. Boadella also echoed some of Lowen's work on posture and developed concepts of Grounding, Centering and Facing that are new developments in the field of Body Psychotherapy and are not to be found in other disciplines that do not work with the body.

Many Body Psychotherapists work significantly with client's breathing patterns. There is a high correlation between client's emotional states and their breathing patterns, and one significant way of working in Body Psychotherapy is to focus on this and explore different ways of breathing. This is not specifically new knowledge (viz: Yoga exercises) but it is refined and applied in Body Psychotherapy in ways that are different and distinctive particularly in that verbal dialogue and processing of emerging emotional material is used. Much has been written about this last point (Appendix 9).

A more contentious area is that of touch. Body Psychotherapists do touch their clients - and they acknowledge it. Other psychotherapists might do, or might not do, and often it is unacknowledged or theoretically restricted. As a result of this acknowledgement much has been written about the affects, the ethics, and the constraints of touch (Appendix 10). As touch becomes more and more restricted through reactions to ethical cases and litigation in the courts, (as is happening in America) Body Psychotherapists will have an increasingly important voice on the side of being able to retain permission to touch clients. They have a critical role in introducing society to the varieties of touch, the subtleties and complexities, positive and negative, indications and contraindications of it's use.

One specific area that has been developing a lot through the last decade is the area of PTSD - Post Traumatic Stress Disorder. Body Psychotherapists have contributed especially concerning the treatment of PTSD, by pointing out the importance of including bodily oriented techniques providing release and reframing of PTSD. Albert Pesso's work (5) could be mentioned among others and so could the work with shock-traumas in Bodynamic Analysis (6 & 7).

We would like to refer to a list of conferences and congresses in Body-Psychotherapy that have been held in the last few years. You will see from the list of topics etc. that new knowledge is constantly being offered in the domain of psychotherapy (Appendix 11)). These Congresses are typically attended by 300-400 people. We append also, as a sample, a list of Congress papers from two particular Congresses so show some of the depth and range of the information (Appendix 12).

We also append at this point a list of 25 Training Organisations, Professional Associations and European Institutes that are currently members of The FORUM of Body-Psychotherapy Organisations (Appendix 13). There are potentially 45 that we know of and are in contact with, though all are not currently ready or willing to join The FORUM at this present moment. (There are also a great number of other European Body-Psychotherapy trainings (particularly in Biodynamic Psychology & Bioenergetics) and in the UK that are not listed here Our database had addresses for 135 at one point.). It can be seen from these numbers that there are at least about 5000 people already trained or in training in these organisations alone. We feel that this is indicative of the interest and of the new knowledge which is different and distinctive to other psychotherapies, given also the discrimination against Body-Psychotherapy and the current lack of uncertainty about registration and certification. Thus not only is there new distinctive and differentiated knowledge within Body Psychotherapy , but it is increasingly recognised by the public.

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