As indicated there have been many overlaps and integrations and also developments from various different psychotherapies throughout the history of Body Psychotherapy. According to Heward Wilkinson (1), the editor of the International Journal of Psychotherapy - the official journal of the EAP - "body-based psychotherapy" is the fourth major direction helping to integrate aspects of psychodynamic, humanistic-existential, and behavioural-cognitive psychotherapy whilst also presenting challenges and this approach "straddles the divisions between humanistic, psychoanalytical and cognitive-behavioural approaches. Many Body Psychotherapists ... would claim plausibly to be both/and in respect of all of these."
We would agree. Further, in the same issue, David Boadella's paper "invites us fully to assimilate and integrate Body Psychotherapy into the perspectives which are (more) familiar - linking it with all the three major psychotherapeutic perspectives addressed in the first issue (of the International Journal)..." The main part of this paper by David Boadella (2) was a Keynote Address presented at the First World Congress of Psychotherapy (in Vienna in July 1996) which suggested that Pierre Janet's work "pioneered body-psychotherapy, together with much that has been rediscovered in , for example, object relations and integrative theory. Body-psychotherapy, accordingly, like hypnosis, is older than psychoanalysis..." Heward Wilkinson later states "David Boadella's two-part paper really sets the cat among the pigeons in a quite straightforward yet massive and scholarly fashion. His claim is that the integrative process implicit in all the major psychotherapies can only be realised through a spirituality expressed through a full realisational awareness of the body. He establishes links with Freud himself, Charcot, Rank, Darwin, Janet, Jung, Bowlby, Reich, Groddeck; the references come thick and fast but also incontrovertible." Thus, with this official endorsement of Body Psychotherapy by EAP, and with the public acceptance of Body-Psychotherapy as a "mainstream" part of psychotherapy at the EAP's Congress in Rome in June 1997 with addresses from the podium by David Boadella, Courtenay Young, Michel Heller and a representative of Bioenergetics, EAP clearly accepts - and this is why this evidence has been quoted at some length in the body of this paper - that Body Psychotherapy is a valid part of the history and development of scientific psychotherapy.
Finally and interestingly, Heward Wilkinson states that: "...in the second part of his paper, he ... comprehensively transmutes the history of our field right from its modern beginnings. ... Why this history was 'avoided' (vermeidet) is a further question. Although to many this will seem a radical emphasis, the paper offers a very clear and straightforward overview of the overall perspective. What is radical about it is just what it says!" - which nicely endorses the point made in the Preamble (Point 1) above at the very start of the submission.
In the last two or three decades there have been some significant developments in integrating Body Psychotherapy with other psychotherapies. Alexander Lowen integrated Reich's work and some Analytical Psychotherapy into Bioenergetic Analysis. John Pierrakos integrated Bioenergetics, which he co-founded with Alexander Lowen, and spirituality into Core Energetics. Ilana Rubenfeld has integrated Gestalt Psychotherapy, Feldenkrais (a body therapy), and Alexander Technique into something she calls Rubenfeld Synergy. Arnold Mindel developed Jungian Psychotherapy and body-oriented dreamwork into his Process Oriented Psychotherapy. Gerda Boyesen developed Reichian psychotherapy and Bulow-Hansens's methods of physiotherapy into her Biodynamic Psychology. David Boadella developed Ola Raknes' and Wilhelm Reich's Body Psychotherapy with some of Frank Lake's perinatal work in Clinical Theology and Stanley Keleman's work into Biosynthesis (which has been accepted by EAP as a scientifically valid psychotherapy). Paul Boyesen has developed his mother's Biodynamic Psychology and Psychoanalytic Psychotherapy into Psycho-Organic Analysis (which has been accepted by EAP as a scientifically valid psychotherapy). There are many other similar examples.
Common areas of references between these Body Psychotherapies and other psychotherapies are also very varied. Many of the actual methods of reducing physiological effects refer more to systemic methods, rather than cognitive. However many of the initial awarenesses to the connections between the body and the emotions; the soma and the psyche, use cognitive changes and frameworks.
Within the framework of this question, Jerome Liss proposes new criteria for scientific research that are more relevant to clinical psychology & psychotherapy and then applies these to some Body Psychotherapy examples (see Appendix 19 ). He also describes the integration of various methods in relation to Body Psychotherapy and concludes that perhaps only an integration of methods is truly effective (Appendix 20).
Edward W.L. Smith (8) could be mentioned as one among many other authors who have recognised the impact of including bodily oriented techniques into psychotherapeutic work. Body Psychotherapists have without any doubt contributed over and over again to several areas of psychology and psychotherapy. Pre and Perinatal Psychology is one of the areas where Body Psychotherapists have contributed, stating ways of how to work with rebirthing techniques. Just one example of this amongst many: Lisbeth Marcher and Lennart Ollars has published a paper on this topic, in Energy and Character (3) as well as in "Nordisk Psykologi", a Scandinavian Journal of Psychology (4).
Our areas of common ground are therefore very varied. There is a common assertion that the body significantly affects the mind and the mind significantly affects the body. It is a continual two-way process. The aetiology of many physical symptoms is often found to be lying in a weakness of the body created by psychological reactions to trauma. What is also common is that the healing or resolution of many psychological and emotional problems is unable to be completed without significant reference to the body, the physiological and the psychosomatic areas. As mentioned previously we, as Body Psychotherapists, are very interested in combining and working with all aspects of the relationship between affect, behaviour, and cognition - all fundamental aspects of scientific psychotherapy - and how this inter-relationship is manifested in and through the body. We provide a "holding environment" for our clients, we mirror and reflect, we engage in unconditional positive regard, some of us offer interpretations or reframes, all also aspects of so called scientific psychotherapy.
(1) International Journal for Psychotherapy; Vol 2, No 1, May 1997; Editorial, p5-11 - All the following quotes in this paragraph are from his editorial: New Wine and Old Wineskins.
(2) International Journal for Psychotherapy; Vol 2, No 1, May 1997; pp 45-56
(3) Lisbeth Marcher, Lennart Ollars: "Bodynamic Analytic Developmental Re-birth Therapy". Energy and Character Vol 22 no. 2 1991.
(4) Lisbeth Marcher, Lennart Ollars: "Kropsdynamisk analytisk arbejde med refødselsterapi" Nordisk Psykologi Vol 41 (3) 1989.
(5) Al Pesso: Abuse. Energy and Character vol. 19 No. 2 1989.
(6) Lennart Ollars: Bodynamic Analytic Work with Assault and Abuse. Energy and Character.
(7) Steen Jørgensen (ed): "Forløsning af Choktraumer". Kreatik Copenhagen, 1993.
(8) Edward W.L.Smith: The Body in Psychotherapy" MacFarland & Co. London, 1985.
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The strategies by which Body Psychotherapy understands human problems have been described elsewhere in this submission as well. In all of the major textbooks about Body Psychotherapy - Bioenergetics (1), Jay Stattman's Unitive Psychotherapy (2)&(3), Lillemor Johnsen's Integrated Respiration Theory therapy (4), Malcolm Brown's Organismic Psychotherapy (5), David Boadella's Biosynthesis (6), Gerda Boyesen's Biodynamic Psychology & Psychotherapy (7), Arnie Mindel's Process Oriented Psychology (8), Charles & Erika Kelley's Radix (9), Al Pesso's system (10), Christine Caldwell's work (11) etc. - they are described at length. [Incidentally these books also provide answers to many of these questions, both implicitly and explicitly.] In all of these writings there are references to the understanding of of the human being as a whole gestalt of body, mind, emotions and spirit, and the deveopment of strategies and interventions to restore homeostasis in all these domains.
Dr Erica Goodstone writes:
"Although each modality of Body Psychotherapy may use a different specific strategy, there are some elements common to the field as a whole.
Jerome Liss discusses one particular aspect within Body Psychotherapy. "The Need For Touch and Holding When Frightened:" One of the reasons for touch-contact and holding-contact during Body Psychotherapy is that the absence of such holding is considered a very important factor in the generation of emotional difficulties (see Appendix 17 ).
These descriptions are also similar to those described in the Open University Psychotherapy Textbook: in a series edited by Windy Dryden: Innovative Therapy - A Handbook. There are also descriptions in an earlier book of the same title "Innovative Therapies" by Windy Dryden and John Rowan with capters on Biodynamics, Bioenergetics and Biosynthesis. (11) Whilst we may disagree with the implication that Body Psychotherapy is an innovative therapy, we appreciate that various Body Psychotherapies are mentioned in a mainstream handbook about psychotherapy. This latter book is a collection of articles that includes four articles about three different types of Body Psychotherapy:
Additionally there is documented, the Theory of Personality (Persönlichkeitstheorie) found in the Emotional Reintegration Institute's Self-Assessment (Appendix 38) for The FORUM of Body-Psychotherapy Organisations' Self-Assessment and Accreditation Process which is sponsored by the EABP and allows European Body-Psychotherapy Training Organisations to get accreditation by the EABP with a view to EAP accreditation. These are just a few examples of the way in which Body Psychotherapy understands human problems, and designs coherent strategies for use towards specific outcomes.
(1) Bioenergetics, Alexander Lowen, (Penguin) 1975 and many other books.
(2) Unitive Body-Psychotherapy, Collected Papers, Vol 1 (AFRA Verlag) 1989
(3) Unitive Body-Psychotherapy, Collected Papers, Vol 2, ed. Güstl Marlock, (AFRA Verlag) 1991
(4) Integrated Respiration Theory/therapy: The breathing me. Birth & rebirth in the fullness of time, Lillemor Johnsen, 1981
(5) The Healing Touch, An Introduction to Organismic Psychotherapy, Malcolm Brown, (LifeRhythm) 1990
(6) Lifestreams, David Boadella (RKP) 1987
(7) The Collected Papers of Biodynamic Psychology, Vols 1 & 2, Gerda & Mona-Lisa Boyesen et al. (Biodynamic Psychology Publications) 1981
(8) DreamBody - the Body's role in revealing itself, Arnold Mindel, (RKP) 1982
(9) Education in Feeling & Purpose, Charles Kelley, (Radix Inst., Ca.) 1974
(10) Movement in Psychotherapy, Al Pesso, (NYUP) 1969 & Experience in Action, Al Pesso, (NYUP) 1973
(11) Innovative Therapy: Dryden, Windy & Rowan, John: Routldge, 1987.
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Body Psychotherapy offers several examples of theories/ models describing normal and problematic human behaviour, including methods of assessment and intervention. Most of these describe the correlation between psychological and social skills on one hand, and bodyposture/bodily energy patterns/patterns of tension and movement on the other. Some of these also correlate to developmental psychology or that is: include how different patterns of human functioning are developed through childhood. Alexander Lowen's work is one example (1), The Character Structure Development Model of Biodynamic is another example (2 & 3). Stanley Keleman's study on embodiment of tensions is also a fairly definitive work (4).
Much of this stems from Wilhelm Reich's seminal work on Character Analysis (5) in which he first postulated the concept of character armour as being the embodiment of the neurotic patterns. His theory - based on pragmatic discoveries stemming from his work in the free psycho-analytic clinic in Vienna in the mid-1920's - in simplistic terms, was that however much you can analyse the neurosis, if the person is still 'bound up' in their character armour (quite literally), they would be unable to respond to the desire to grow and change without this armour being actually dissolved. He thus started to work on the body, on the actual muscular tensions that were present and detectable and discovered that as he did this and encouraged emotional content (instead of intellectual analysis), so the defences came to the surface and the neuroses got worked with and there was a corresponding change in the physical holding patterns of the body. He presented his work to the 10th Psycho-Analytic Conference in 1927. All this and the subsequent split with psychoanalysis is well outlined in David Boadella's book: Wilhelm Reich, The Evolution of his Work (6).
Reich's main theories of the etiology of neuroses was in the sexually repressive attitudes in society. This caused him to go towards the very popular (then) Communist theories of restructuring society and caused him to set up the SexPol Clinics. These developments cemented the split with psychoanalysis, which is essentially conservative and did not wish to change the status quo in society in order to cure individual neuroses. Since then much more work has been done. Frank Lake has written another seminal work on the development of neuroses from birth and infantile traumas (7), drawing in part on Reich's work in understanding childhood patterns, but he went much further than Reich did. Gerda Boyesen developed Reich's work in a very different way and discovered that a significant part of the neurotic holding pattern in the body is tied up in the intestinal system through the (lack of) interaction in the autonomic nervous system (8). By encouraging healthy activity in the gut (through her Biodynamic Massage), we can begin again to digest residual emotional tension and thus do not have to embody the undigested bits.
Lisbeth Marcher talks about the need for the human being to progress through certain movement patterns (also discussed in the work of Bonnie Bainbridge Cohen (9)) and the need for repatterning through either direct exercise or visualization as an intervention when there is emotional disturbance due to the lack of integration of certain patterns (10). Peter Levine also talks about the need for movement patterns in response to trauma and employs movement in order to change the neuromuscluar patterning stuck in the body after trauma (11).
There is also an interesting phenomenon of the integration of therapy with movement with a systemic model by Al Pesso (12).
(1) Alexander Lowen: Bioenergetics. 1975 Penguin Books
(2) Peter Bernhardt, Marianne Bentzen and Joel Isaacs: "Waking The Body Ego. Bodynamic Analysis: Lisbeth Marcher's Somatic Developmental Psychology. Part I: Core Concepts and Principles" Bodynamic Institute 1997
(3) Peter Bernhardt, Marianne Bentzen and Joel Isaacs: "Waking The Body Ego. Bodynamic Analysis: Lisbeth Marcher's Somatic Developmental Psychology. Part II:Psychomotor Development and Character Structure". Bodynamic Institute 1997.
(4) Stanley Keleman: Emotional Anatomy (Center Press) 1985
(5) Wilhelm Reich: Character Analysis (Farrar, Strauss & Giroux) 1972 - originally published 1933.
(6) David Boadella: Wilhelm Reich, The Evolution of his Work (Arkana) 1985
(7) Frank Lake: Clinical Theology - A Theological and Psychiatric Basis to Clinical Pastoral Care (Darton, Longman & Todd) 1966
(8) Gerda & Mona-Lisa Boyesen, et al: The Collected Papers of Biodynamic Psychology Vol 1 & 2 (Biodynamic Psychology Publications) 1980
(9) Bonnie Bainbridge Cohen: Sensing, Feeling, and Action: The Experiential Anatomy of Body-Mind Centering (Contact Editions) 1993
(10) Linda Hartley: Wisdom of the Body Moving: An Introduction to Body-Mind Centering (North Atlantic Books)1995
(11) Peter Levine: . A., Frederick A.: Walking the Tiger. Berkeley: North Atlantic Books, 1997.
(12) Pesso A.: PBSP - Pesso Boyden System Psychomotor. In Caldwell C. (ed.): Getting in Touch. Wheaton: Quest Books, 1997.
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Again this question must be viewed in the light that we represent many different types of Body Psychotherapy. For example: there are two significant Ph.D. theses on Body Psychotherapy from the Austrian Emotional Reintegration school alone (1). Below are included three descriptions of how scientific investigative procedures are being applied to different areas of Body Psychotherapy: in the first, John Pierrakos' Core Energetics (based in New York but with trainings in Germany and other European countries) and the second relates to Biosystemic Therapy, a Body Psychotherapy developed by Jerome Liss, based in Italy. This second description (see Appendix 18) explores three specific applications of investigative procedures (clinical description of a session; the use of video recordings of a session; and the use of designs in a text)which he puts forward as proposals for any Body Psychotherapists doing clinical research. The third description speaks for itself.
Dr. Mary J. Giuffra, a Professor of Research at New York University and a Body Psychotherapist (& Vice-President of USABP) writes:
"As a profession, we are in the phase of designing theory-developing research studies that are exploratory and descriptive in nature. To accomplish this, we are using qualitative and unstructured data. Our analysis includes content analysis and constant comparison, case studies, descriptive statistics, charts and graphs. As a result of our exploration, we are developing a description of processes, concepts and phenomena specific to Body Psychotherapy.
For example, Core Energetics describes love as an important component of the core and an access point for the therapist. Through a qualitative research study, we are interviewing clients and therapists to explore their lived experience of love. Through a structured interview questionnaire, we are exploring the meaning of love for each person studied. From this, we will develop patterns of responses and themes describing the experience of love on a mental, emotional, physical and spiritual level. This method of qualitative research will be employed to study concepts such as energy, sexuality, consciousness etc.
As we develop more data describing the phenomena and processes with which we work, we will further develop the theoretical underpinning for Body Psychotherapy. This in turn will lead us to the next phase in our research process. We will then begin to study the relationships between or among the variables with which we work. From our theoretical base, we will develop hypotheses. Through correlational analysis or tests of association and by testing differences between group means we will support or reject our hypothesis and more scientifically explain relationships among variables. We can examine the relationship between certain processes in Body Psychotherapy and physiologic, emotional, relational or mental expressions in clients.
With the scientific findings from the first two phases of the research process, we will move to the level of experimental research, confident that our theoretical base has been developed scientifically. In this case we will develop hypotheses from the theoretical base, assign participants to groups randomly or non randomly depending on the design of the individual study..As a result, we will test the theory on which Body Psychotherapy is based. Concurrently, outcome research on Body Psychotherapy will be conducted since insurers find this type of data invaluable in making decisions. For example, we will explore the outcomes on self-care, health status, satisfaction with relationships, career, etc., following a regimen of Body Psychotherapy. Given our plans for the scientific study of this discipline, we feel confident that the research structure we have established will insure the public and members of other health professions that the profession of Body Psychotherapy is based on a theoretical and intuitive body of knowledge that has been developed in a scientific manner."
Prof. Jerome Liss emphasises that 'Science Means Ideas Linked to Experience.' (2) The fundamental principle of science (he writes) is that it is a relationship between ideas and concrete experience. Prof. Hempel states, "Science is ultimately intended to systemize the data of our experience, and this is possible only if scientific principles, that is our theoretical constructions, have a bearing upon, and thus are conceptually connected with, statements reporting what has been established by immediate experience."(3) To put it in a nutshell: when we base our ideas on concrete experiences, we have science. Without concrete experience, no science. Thus, to repeat an argument in an earlier critique: scientific books and articles in psychology, especially clinical psychology, frequently present little or no evidence, that is, little or no reference to precise concrete experiences. Thus, they are not obviously scientific. To be obviously scientific, we must link ideas to experience. To cite Prof. Carl Hempel: "A theoretical system without empirical observations is incapable of test and thus cannot constitute a theory of empirical phenomena. We shall say of its terms as well as of its concepts that they lack empirical import." (p.39)
This fundamental notion of science, linking precise empirical observations to theoretical concepts, permits a new perspective for the Body Psychotherapist. It means that the clinician can use his own case-studies, and even single sessions, in which there are unique and non-repeatable events, as the empirical basis of his scientific theorisation. But there is still a need for "rigour." This rigour is, first, in the adequacy of his registered empirical observations, then in the clear-cut connectedness of his first level ("operational") concepts, and then in his establishment of "scientific fruitfulness."
The "effort" of science in Body Psychotherapy (where we are trained to observe the client's body as well as record what they are saying) can thus change direction. At the moment of obtaining data, the "effort" of the clinical researcher (and, as can occur, the clinical therapist-researcher,) is channelled toward accurately registering all of the pertinent observations. This requires less effort over time, since it is not necessary to keep repeating the same experiment over and over as in traditional science. On the other hand, this approach requires a greater effort during the period of observing the registered data and compiling the results, which means either giving a description or else a quantitative analysis. Thus, to observe complex and non-repeatable events and then transmit the observations into a transmittable form requires new capacities on the part of the scientific psychotherapist (4). A more complete account of what is required in order to have adequate observational data and appropriate operational concepts is as follows: In order to link our ideas to observations, Prof Liss proposes:
His conclusion is that all psychotherapeutic orientations need more specific methods for communicating their "fields of study," meaning for registering their concrete case material in order to reveal to the scientific community their treatment approaches and Prof Liss asks what "methods" for registering case material would be "scientifically rigorous" in the field of psychotherapy and of Body Psychotherapy in particular? (see Appendix 18)
Experimental research on how the body participates in psychotherapy processes is therefore being carried out from both an experimental and clinical perspective in a more coordinated way. In Europe, this has been achieved by Rainer Krause for a psychoanalytic perspective, with studies on object relationship, unconscious communication, and diagnostic. Dr. Michael Heller has followed a parallel path for body psychotherapies.
Michael Heller followed a double career of experimental research on nonverbal communication, and as a psychotherapist integrating bodily dimensions in his work. For 11 years he created a method to analyze postural behavior systematically for his doctoral dissertation in the Universities of Geneva (Switzerland) and Duisburg (Germany). This study focused on the coordination of biological and social requierments made on postural dynamics. For 11 years whilst he was the director of the Laboratory Affet & Communication, in the Geneva Psychiatric Institution, he analyzed nonverbal communication between psychiatrists and suicidal or depressive patients. At the same time he trained in Biodynamic Psychology, and opened a practice as Body Psychotherapy in 1976, and between 1984 and 1990 he trained Body Psychotherapists in Austria, England, France, Germany, and Switzerland, bringing much of his research findings into his teaching.
His research on posture has translated common techniques used for postural analysis in body techniques into a detailed coding technique which yields data that can then be analyzed using statistical and computerized techniques, in collaboration with other laboratories of Europe and USA. He used his experimental work in the Geneva Psychiatric Institution to analyze certain aspects of the nonverbal communication happening between a doctor and a patient which can help to increase our understanding of suicide risk and unconscious communication. Bouhuys, Ellgring , Frey and are also checking experimentally known clinical hypotheses (Widlécher) on the rapidity of movements among depressive patients. These are only some examples where clinical and experimental research progress is helping each other. Other examples have been mentioned elsewhere and in our bibliography.
We have earlier mentioned a study made by Lennart Ollars in 1980: "Reliability of The Bodymap". Copenhagen 1980. (see Question 3: References and Appendix 27) This study points out a series of possible "body-mind" research projects addressing both the question of reliability and the question of validity. EABP also has its own Scientific Committee. This has started to meet regularly and has produced one major report. This is appended (see Appendix 29).
(1) (a) Mag. Ursula Nussbaumer: Zur Persönlichkeitstheorie in der Körperorientierten Psychotherapie (Diplomarbeit an der Grund- und Integrativwissenschaftlichen Fakultät der Universität Wien), June, 1988.
(b) Mag. Irene Rautner: Veründerung psychischer und physischer Befindlichkeiten durch Behandlung mit Emotionaler Reintegration (Diplomarbeit an der Grund und Integrativwissenschaftlichen Fakultät der Universität Wien, 1994)
(2) Liss, Jerome, "An Epistemological Protocol to Create a Scientific Psychology: The Application of Carl Hempel's Epistemological Program to Daniel Stern's Research," 1999, 39 pages. (submitted for publication, with the recommendation of Prof. Daniel Stern, to Devenir in France and to Human Evolution and Attachment in England).
(3) Hempel, Carl, Fudamentals of Concept Formation in Empirical Science, International Encyclopedia of Unified Sciences, Vol. II, No. 7, Chicago, University of Chicago Press, 1952, p.21.
(4) Liss, Jerome, "The Philosophy of Science and the Clinical Researcher: A Proposal for a New Scientific Psychology," published in Italian: "Filosofia della Scienza e la Ricerca Clinica: Una Proposta Per una Psicologia Scientifica Nuova," in Psicologia Clinica (ed. Prof. Mario Bertini, Université di Roma "La Sapienza"), Vol. 2, No. 2, May-August, 1983, pp. 143-163, and in La Psicoterapia del Corpo, (by Liss, Jerome and Boadella, David), Rome, Ed. Astrolabio, 1986, Chapter XIV.
(5) Liss, Jerome, "An Epistemological Protocol...", op. cit., p. 35.
However this submission is necessarily incomplete. This is an on-going exercise. Many references have not been included. However it is felt strongly that sufficient information and references have been given to establish the case for the scientific validity of the field of Body Psychotherapy.
We have drawn on a number of different disciplines and a wide source of references. Many of these references could also have been used in other parts of the submission. We decided not to duplicate too much. We have also decided to include some lengthy appendices as they give, for different reasons, a distinct flavour of the work of Body Psychotherapy, which, whilst referring to one aspect of the field, have common ground with many other aspects.
This submission has been specifically helped by a number of people working over the e-mail both in Europe and world-wide. It has been put onto the EABP website and updated regularly and people have viewed it from there and then added parts and contributions - a truly collaborative and open-minded venture. Their help has been invaluable. Our heart-felt thanks are extended especially to Dr. Michael Heller, Prof. Jerome Liss, Dr. Peter Bolen, Dr. Lennart Ollars, Dr. Mary J. Giuffra, Dr. Erica Goodstone, Dr. Laura Steckler, David Boadella and many others.
EABP General Secretary
© European Association of Body Psychotherapy, May 1999
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