© Mark Ludwig MSW, Somatic Psychotherapy/Biosynthesis, Oakland, California, USA
How should Body Psychotherapists look of recent gene research that indicates a strong role for genetics in the creation of human experience and behavior? This controversial information is often rejected by psychotherapists who feel threatened by what they see as an implied determinism. We have fought for the body's place in therapy but are we ready to accept ALL of this body or only those parts which fit the liberatory intent of our tradition? One aspect of "the body we work with" may be it's underlying organic predispositions or "pre-personal" (Keleman) aspects that come, in part, from the actions of genes. Is our work diminished by this evidence or can we create personal and professional maturity by meeting the genetic revolution with human values? Among the topics to be addressed are new research on mood and temperament genes, implications for the concept of character, and the acceptance of human difference and imperfectability.
Presentation at the 1999 European Association for Body Psychotherapy Congress at Travemunde, Germany (Sept 1999) 
THE RELATIONSHIP BETWEEN GENOTYPE, TEMPERAMENT AND BEHAVIOR IS ENORMOUSLY COMPLEX AND INTERESTING. As we, in the Body Psychotherapy community might expect, neither the "nurture" nor the "nature" side of that classic conflict has won the day. From a body-psychotherapy view this is predictable because we understand that the person and their experience is a synthesis of personal, interpersonal and biological forces. Nonetheless, behind the scenes, in another new field, there is a revolution going on. The new field of Behavioral Genetics is uncovering information that may be important in a number of dimensions for the daily practice of psychotherapy. Behavioral geneticists are verifying on a daily basis, ever more precise relationships between specific gene sites and specific biopsychological processes that influence individual psychology and behavior. At the same time this research is helping to clarify the flexible nature of temperamental predisposition, more precise actions of "environmental" influence on development, the process of character development, and the self-creative human dimension called "free will".
One dimension of " the body we work with " is the genetic inheritance of a person. Accounting for the psycho-biological influences of this infinitely complex system is of course beyond the scope of daily clinical practice. However, the recent research in this field raises some interesting questions for psychotherapy in general and for body psychotherapy in particular. For analytic based psychotherapy the question of genetic influence on personality can raise the thorny issue of the bio-genetic vs the psycho dynamic roots of experience and behavior. For Reichians, who work with so much more of the person's structure, the questions become more complex. If function creates structure (Reich) and structure creates experience (Keleman) how do we weigh the psychosomatic influence of a genetic system that participates strongly in the shaping of the processes and forms of the body? In this talk I will try to clarify some of the results of recent gene research and it's possible implications for clinical theory and practice. Because in Body Psychotherapy we already know that the body is the person and that physiology effects experience, I expect that our community will be more open to considering this new information.
Recent Research Findings on the Genetics of Temperament and Perceptual Style
Behavioral Geneticists are uncovering some of the genetic factors in behavior and perceptual style. The two most precise and verified genetic links have been isolated and localized to particular segments of DNA strands. These strands have been found to have variations in size and organization that corresponds to differing levels of production and uptake of the powerful neurotransmitters- dopamine and serotonin. Dopamine levels are associated with pleasure, motivation and the feeling of vitality while problems with serotonin (the most widespread neurotransmitter in the brain) transportation and re-uptake is related generally to the symptoms of depression and anxiety.
A number of experiments have shown "that everybody has a gene that makes serotonin transporter, but they make different amounts based on inherited structures). About 32%..of the population have two copies of the longer, more powerful form of the gene ( for serotonin transporters) and therefore make high levels of serotonin transporter. The remaining 68% have one or two copies of the shorter version of the gene which is dominant, so they make less of the transporter." (Hamer and Copeland). Serotonin that is not transported and reabsorbed can spread through the extensive serotonergic system laid out in the limbic system, the cerebral cortex and areas effecting impulse control, empathy, social awareness, memory, learning, as well as appetite and sex. In this sense the term "free-floating" anxiety is a literal description of the effects of unreabsorbed serotonin.
Dopamine one of the "chemicals responsible for pleasure and rewards" is an"activator of behavior. It energizes people to seek out things that feel good and it causes pleasure when those things are found". Higher levels of dopamine receptors (more receptors means more effect) has been linked to genetic anomalies expressed as different patterns of DNA sequencing. "People with 1 or 2 copies of a long version of the gene, containing 6 or more repeats scored 50% higher(on standardized psychological tests) for novelty seeking...the longer the gene, the more the person claimed a desire for new and exciting experiences" (Hamer and Copeland).
As a result of this research, two "genetically influenced temperamental traits" have been isolated and described.
(In addition, strong evidence is emerging from genetic research that the following personality factors also have a genetic component......Reward dependency, persistence, intelligence, memory, sensitivity to stress, levels of aggression, levels of traditionalism, social closeness, positive and negative emotionality, constraint, general activity levels, shyness and sociability).
Much has been made in the press about a related topic in recent research which finds that one's "sense of well-being" has a strong genetic component. Clearly information on the genetics of neurological chemistry are relevant here. Eliminating environment, health and financial influences researchers using interview protocols have found that "About 1/2 of your sense of well-being is determined by 'set point' which is from the genetic lottery, and the other 1/2 from the sorrows and pleasures of the last hours, days and weeks"
According to researchers (Verneulen) our genetics is most expressed in the limbic and reptilian brains as the cortex is, by design, intended to be shaped to a greater degree by experience and learning. Since sensation passes through the limbic brain before the cortex, the notion is that our way of perceiving is prone to limbic/genetic influences because this area is so neurochemically sensitive.. "The limbic system pays attention to what drives us genetically. It asks ' What is our motivation ?' ". In this sense genetic variations in dopamine and serotonin processing predisposes our sense selection and motivations for action. Clearly it is not difficult to understand how the presence of both these two traits in the human community would favorably benefit our chances for survival...conservative and exploratory impulses are the dual strokes of our history and evolution.
It has been known for some time that serotonin and dopamine were powerful neurochemicals with powerful psychological effects. What is new here is the evidence of inborn and constant chemical tendencies and attending psychological predispositions. By "genetically influenced temperamental traits" is meant that some portion of the traits presence is due to heredity. In the case of thrill seeking and harm avoiding, these traits were found in sibling and twin studies to be in the range of 50% genetically dependent. Other factors would include shared and non-shared environmental factors from personal experience to cultural forces. Below I will explore some of the potential implications for clinical understanding when we look as these two very common personality dimensions as organic rather than psychogenic or characterological.
Nature vs nurture revisited
Such research findings begs the question...What makes us the way we are? Traditionally psychodynamically oriented therapists have been on the "nurture" side of the nature-nurture issue, looking to historical interpersonal and other experiential-environmental factors to account for the roots of the problems in a client's current functioning. Believing that how we are treated as children accounts for our later happiness and adjustment to life, dynamicists are offended by suggestions that nature might just be taking it's course in these difficult lives. But, more recently, psychodynamically oriented researchers like Daniel Stern and other infant observers have also come out to make a strong case for the presence of an inborn, organic personality or temperament which emerges as the infant begins to interact with the environment. In so doing they are beginning an important dialogue within the nature -nurture debate. Schore and others take the question of bio-vs psychogenic roots of behavior farther and make a strong case that" genetic inheritance is only partially expressed at birth. The process of development of biological and psychological structures unfolds throughout infancy and is influenced by post-natal environment" Later he goes farther.... " In the latest neurochemical models of critical (developmental) period events, external influences are understood to mediate alterations in a hierarchy of internal regulatory signals-neurohormones and neurotransmitters-that act as internal clocks to coordinate the timing of developmental processes. It is well known that hormones regulate gene transcription. In this manner, external relations with the mother could regulate internal genetic events" Genes linked to temperament influence parental response to the child and the parental response in turn can activate or soften the effects of genetic predispositions.
However you look at this debate the growing evidence of the extent of "natural" psychological predispositions will have some influence on the way we look at psychotherapy and the roots of the self in the future...
Temperament vs Character
Temperament is not a new concept. In the history of ideas many organic explanations have been created as to why there are different "types" of people, i.e. what the "something" is in the way we are made up that makes us different and the way we are. The Greeks had their "humors" (choleric, sanguine, phlegmatic and melancholic), 4 personality types said to emerge from the particular conditions of humidity and temperature associated with an individual's birth.
What might surprise you is that this theory, based on so little, has actually had an influence on several modern theorists. Adler, for example, related these types to his four personalities.) But, more to the point, Ivan Pavlov, of classical conditioning fame, used the humors to describe his dogs' personalities. One of the things Pavlov tried with his dogs was conflicting conditioning -- ringing a bell that signaled food at the same time as another bell that signaled the end of the meal. Some dogs took it well, and maintain their cheerfulness. Some got angry and barked like crazy. Some just laid down and fell asleep. And some whimpered and whined and seemed to have a nervous breakdown. Pavlov believed that he could account for these personality types with two dimensions: On the one hand there is the overall level of arousal (called excitation) that the dogs' brains had available. On the other, there was the ability the dogs' brains had of changing their level of arousal -- i.e. the level of inhibition that their brains had available. Lots of arousal, but good inhibition: = sanguine. Lots of arousal, but poor inhibition:= choleric. Not much arousal, plus good inhibition:= phlegmatic. Not much arousal, plus poor inhibition:= melancholy. Arousal would be analogous to warmth, inhibition analogous to moisture!
Practitioners through the ages, including those in the ancient medical tradition of India, have noted the relationship between physical structure and personality. In his classic studies of personality Sheldon looked for the organic and structural link between temperament and the body . He studied embryogenesis and the different personalities associated with the relative dominance of the three embryodermal tissues in the 3 body types - endomorph, mesomorph and ectomorph. Both Keleman with his Formative Psychology and Boadella in Biosynthesis have built on and enhanced the Steiner-Hartmann-Sheldon thinking in this area.(there are also roots in this tradition going to Rudolf Steiner and Hartmann's "Dynamic Morphology").
Keleman in particular has given considerable emphasis in his work on the psychological consequences of our "pre-personal" self which includes our general human form and our genetic legacy and thrust. (As our organism has developed over time, it has created the body shape it needs to function and grow and has, as a result, changed the experiential and self-reflective range of the human being. This range is codified in the DNA which has adapted and become more complex through the ages.)
How does "Character" fit into this model? For Reich, character was thought to be a mask and a mass psychoenergetic compromise with a repressive culture...... not natural in any manner. Obviously this does not fit the evidence for temperament. At any rate, Reich was not so interested in individual differences but in mass phenomena like the effects of sexual repression on the minds of "little men", and the actions of huge energetic systems. "Character" as it is used today in contemporary body psychotherapy still carries some of this objectifying rigidity in thinking and needs to be clarified. I prefer the language of Winnicott and his true and false selves. Temperament would certainly have some relationship to the true self. The danger as I see it that over concern with character diagnosis might reduce our sensitivity to what is natural, if different than ourselves perhaps, in the temperamental nature of our clients. Thinking in such a "soft" concept as 'temperament' may seem like pop-psychology but the new research evidence is also an invitation to reconsider what part our clients presentation is a true expression of naturally occurring and randomly distributed psychological predispositions before we jump to characterological conclusions. Character used in the hard Reichian sense may influence us to see pathology where only differences exist.
Behavioral Geneticists see the relationship of temperament and character quite differently. As Keirsey writes "Temperament is the physical base from which character emerges...it is the inborn form of (ones) human nature (while) character is the emergent form which develops through the interaction of the temperament and environment...... Temperament is seen as a configuration of inclinations, a predisposition - something like computer hardware. Character is more like a configuration of habits, something we are disposed toward doing, and more like computer software." Computer jargon aside, this model is more like Winnicott who also saw that a true nature could be hijacked by the environmental deficits. Ideally, the mature true or "essential" self, integrated with the functioning ego, would be able to perceive the nature of it's own temperament and manage and adjust it's impact. Similarly, one behavioral genetics researcher defines character as 'how we handle the dual exigencies of our nature and the environments demands', seeing in the process the self-creative and "free choice" or decisional dimension of character. "Free will is experienced at the moment only when we override our temperamental predisposition" (Verneulen).
Perhaps temperament is a sub-characterological level that both predisposes us to a particular perceptual and behavioral style and also creates patterns of environmental reaction to ourselves, further generating "character building" experience.
Clinical Issues
Some interesting clinical issues emerge when we seriously consider the issue of temperament.
Developmental and Therapeutic Attachment
Evidence of genetic temperamental predisposition concretizes what attachment researchers and other infant observers have been saying for some time. Babies are not blank slates. We are born with a personality and temperamental needs. We have a comfort level for experience and a variable capacity for integration synthesis of sensory experience. Our need for and ability to respond to contact and gaze are our personal perimeters. The same with our activity levels, curiosity quotient and capacity for self calming. "Sensitive Responding" to these variables is the issue in parenting and clinical practice. Clients who are parents need to have this information about temperamental predispositions to be able to orient themselves in an open way to their newborns. Therapists ought to know there own temperament just as well as they expect themselves to know their own psycho dynamic issues through their personal therapy. As in parenting, matches and mismatches are inevitable but ameliorated by parental and therapist education and self-knowledge. In may if fact be that in many cases the magic of the "good match" will appear as unremarkable and only the mismatches will stand out.
Assessment, Diagnosis and Treatment
Misinterpretation of biogenic temperament for psychogenic dysfunction is the greatest concern in the area of assessment and diagnosis. What is temperament and what is clinical syndrome or character in the Reichian sense? If we hold a value on an individuals ability to experience the range of behaviors form containment to impulsiveness and they are predisposed in one of these directions is that a problem in the client or in our misconstrued values? Assessments of "health" are always culturally biased. Of the two genetically influenced temperaments discussed here it is clear that the "activity seeking" character is closer to our modern cultural ideal and hence more likely to get under the diagnostic radar or to be seen as "healthier" than the naturally careful personality tendencies of the "harm avoider". This requires a more careful look at possible assessment biases. Naturally this also applies to personal biases on the part of the therapist and any qualitative judgments they may make in either direction based on their own temperament. Is there a degree of habitual carefulness for instance that does not imply repression, depression or compulsion? How do we make these evaluations in a respectful and clinically accurate manner?
Extensive research has make a very strong case for at least partial genetic predisposition in cases of major mental illness and mood disorders. The closer the blood connection and the more incidents within a family the greater the statistical likelihood of problems of this nature. How should this information effect the way we counsel those with these problems and their families? How do we look differently at theories of psycho dynamic etiology? The "schizophrenogenic family? When do we recommend "genetic counseling" for those clients who fear passing on their own or their gene pool's psychiatric problems to possible offspring?
Finally, we have the question of "who seeks therapy?" If we accept a degree of "natural" predisposition how does this effect who is coming to our offices (e.g., do more "harm avoiders" seek therapy?) and how are we to consider this genetic component in our choice to "treat" or not?
In treatment several issues come to mind....... There is rapidly growing evidence of the biogenic/genetic component in Alcohol and Substance Abuse. How does this effect etiological thinking and treatment planning in these cases? One of the therapeutic tasks will be to help clients come to terms not only with their personal history but also the pre-personal history of their predispositions. If we all have these tendencies in our nature shouldn't we know about them and bring them, like other parts of the "unconscious", into consciousness?. If as some body psychotherapists have said, the body IS the unconscious, isn't our genetic motivations part of this body-unconscious? In considering technique in body psychotherapy, will we attract and reinforce the temperament of "thrill seeking" clients by employing strongly affective and stimulating somato-emotional methods? How will we know if we are doing that? Finally, one of the often hidden values held by the psychotherapy community is the myth of the perfectibility of the human being and the supposed benefits of unceasing self evaluation and personal striving to be "better". More attention to self-acceptance (which I suggest would include temperamental self acceptance) as suggested by the late Bioenergeticist, Dick Olney, would seem to be a more truly humane and healthful value and one that would go far in relieving the sense of personal failure clients often suffer with when they can't change some part of themselves. The expectation and acceptance of human difference should guide clinical practice.
Addendum: A few facts about genes
Genes are chemicals that direct the organization of other chemicals. Genes are chemical information.
The chemical that makes up genes is called DNA. The chemical information in DNA converts to proteins. DNA is the building and functioning plan of the mind and body.
Proteins/amino acids act as enzymes that convert, make, degrade, structure and direct other chemical processes in the body.
Each of our 10 trillion cells has it's own set of 100,000 genes organized into sets of 23 chromosomes.
A few genes make a lot of difference. We share 98% of our DNA with the higher primates. We share more than 99.9% of our genes with all other humans. Of the 3,000,000,000 chemical bases in our DNA only 3,000,000 or 1 bit per 1000 vary from person to person. These are the bits that account for all inheritable features and variations between individuals.
Genes are not active all of the time. They may participate in a time-limited and phased manner. Some genes, called "recessive", are passed along and never exert any effect on their carrier. "Modifier" genes have no direct action of their own but have small quantitative effects on the level of expression of another gene.
Some genes may be turned on and off by stress, hormones, age and other changing conditions.
Inheritance is a poly-genetic process. With a few exceptions (e.g. Huntington's Disease) there is no general agreement as to how and what specific genes are organized to affect any particular trait, process, or structure in the body.
"To preserve genetic material, genes encode only what is absolutely necessary to create structures and function. The rest of the detail is left for the environment to fill in"
Regarding genetic effects on personality there are two theories.
1 The OGOD (one gene, one disorder) hypothesis holds that" complex traits are made up of several component traits, each of which are influenced by a single gene". (Chaim, Singer, and Weinberger)
2 The Qualitative Trait Loci theory holds that various genes, different in shape and size, contribute as a group to one trait.
Regardless of what theory you hold ,"genetic factors cannot act directly on behavior: there must be an intervening link between (genetic material) on one hand and social behavior on the other" (Eyesnk, 1991). That "intervening link" is the complex psychosomatic processes of the conscious and embodied person.
Bibliography
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(http://www.mentalhealth.com/mag1/p5h-beh2.html)
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"Mood genes: the hunt for the origins of mania and depression", Barondes, 1998 Freeman Press
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