The
New
Therapy
INNER BODYWORK
The New Therapy
(full article)
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1. Introduction
2. The Principles of Soma-psychology
3. Soma-Sensitivity and Somatic Resonance
4. The Resonant Healing Process
5. Medicine and Soma-psychology
6. Bibliography
Soma-psychology
and Soma-sensitivity
A
missing dimension of psychotherapy
Peter Wilberg
Behind your thoughts and
feelings my brother, there stands a mighty ruler,
an unknown sage –
whose name is Self.
In your body he dwells.
He is your body.
Friedrich Nietzsche
Psychiatric services
concentrate primarily on the symptomology, neurophysiology, and
pharmacotherapy of mental illness. Counselling and psychotherapy offer
‘talking therapies’ focused on the client’s mental-emotional states.
Social work concerns itself with the provision of managed social care
for the mentally ill. Approaches to mental illness which concentrate
either on mental-emotional states or on brain chemistry, however, tend
both to encourage a lack of sensitivity to the somatic dimensions
of the client’s experience of mental illness. In ‘soma-psychology’,
terms such as ‘soma’ or ‘somatic’ do not refer to the physical body, but
to the client’s own inwardly felt body, in particular their
felt bodily sense of dis-ease or distress and their felt bodily
sense of self – or lack of it. The central thesis of
soma-psychology is that pharmacotherapy and psychotherapy are effective
only to the degree to which they not only alter the client’s
mental-emotional state or mood but deepen (a) their felt bodily
sense of self and (b) their felt bodily sense of connectedness to
others. Unfortunately both psychopharmacology and counselling or
psychotherapy can also have the very opposite effect. Treatment with
psychiatric drugs tends to numb rather than deepen the client’s bodily
sense of self and of connectedness to others. Counselling and
psychotherapy, cognitive therapy and emotional empathy can all become a
substitute for deep bodily sensitivity – ‘soma-sensitivity’.
In the theory of
soma-psychology and the practice of soma-sensitivity
terms such as soma and somatic do not refer to the
physical body of the client, but to their subjectively felt body – to
their felt bodily sense of dis-ease, their felt bodily sense of self and
their felt bodily sense of connectedness to others. Phenomenologically
understood, ‘dis-ease’ in any form, psychical or somatic, arises from a
sense of ‘not feeling ourselves’. Only through feeling our body
as a whole, can we once again ‘feel ourselves’ – feel our self as a
whole and therefore feel ‘whole’. Our own whole-body awareness can also
turn our body as a whole into a “sense organ of the soul”, allowing us
to directly sense the ways in which a patient or client lacks a
full bodily sense of self and connectedness to others that is the basis
of all dis-ease. The body as a whole (soma) is a sensory image of
the soul (psyche). The client or patient presents themselves
first and foremost not simply as a ‘person’ but as a body. To
truly receive and respond to the ‘whole person’ is impossible without
sensitivity to the whole body of the client – soma-sensitivity.
Generally however, health professionals pay very little attention to
awareness of their own bodies and that of their clients. Yet when
individuals turn to health professionals for help, they are not just
seeking medical diagnosis and treatment and/or emotional empathy,
insight and support. They are looking for someone capable of fully
sensing and receiving them as ‘some-body’ - not just a ‘talking head’ or
therapeutic ‘case’. By this I mean someone with sufficient awareness of
their own body as a whole to sense those unformulated somatic dimensions
of a client’s psychical dis-ease that are so difficult to formulate
verbally. The body as a whole is also a sense organ of the soul.
Not finding professionals with sufficient whole-body awareness to sense
and ‘resonate’ with their own unformulated, bodily sense of dis-ease,
the client may feel no choice but to continue to communicate this dis-ease
or ‘pathos’ through some form of diagnosable ‘pathology’ – mental,
physical or social.
The theoretical framework of
soma-psychology offers a relational model of
psychopathology, in line with leading edge trends in Relational
Psychoanalysis. The ‘primary relation’ addressed however, is the
individual’s relation to their own felt body and bodily sense of self.
Different recognised psychiatric disorders are understood not as mental
or emotional disorder, not as expressions of physical brain or body
dysfunctions but as distortions in the individual’s relation to
their own felt body.
In many current forms of
mental health treatment the meaning of a client’s pathology is
sought in a hypothetical ‘cause’ or represented in the concepts,
categories and constructs of a specific theoretical model. In contrast,
the theory of soma-sensitivity follows the work of Eugene Gendlin in
acknowledging that meaning or sense is something that can be
directly felt and sensed in a bodily way – and that the felt
bodily sense we have of a client’s problem can provide a deeper
foundation for intellectual insight and sensitive response than any
pre-established ‘body’ of theoretical concepts, diagnostic categories,
or therapeutic techniques. It complements Gendlin’s understanding of
“bodily sensing” or “felt sense” by showing their relation to the
sensed body and felt self – the ‘inner body’ and ‘inner self’
of the individual.
Like the training
methods developed by Gendlin, the evidence-base of
soma-sensitivity training is research into the principal factors which
facilitate genuine therapeutic change in any relationship,
professional or personal. Gendlin’s groundbreaking work on the
importance of bodily sensing in psychotherapy arose from research
into the distinguishing characteristics of those clients who,
independently of the nature of their own presenting problem and the
particular approach of the practitioner, were able to benefit
from therapy. His conclusion was that such clients were naturally able
to use bodily sensing to (a) feel for words with which to express
otherwise murky or unclear aspects of their experience, and (b) check
out whether their own or other people’s verbal articulation of a
problem was in resonance with their direct somatic experience of it.
From this insight arose a new basic principle of therapeutic practice,
a principle which provided at the same time an important new way of
evaluating the efficacy of therapeutic interventions in situ.
“Moment
by moment, after anything a person says or does, one must attend to the
effect it has on what is directly experienced. Does a given statement,
interpretation, cognitive restructuring or any symbolic expression bring
a step of change in how the problem is concretely, somatically
experienced?…If there was no effect, we can discard what was said or
done.”
‘Focusing’ is the name Gendlin gave to a set of simple but highly
effective methods which could help precisely those clients who had
difficulty benefiting from therapy. The techniques of Focusing
concentrate on helping the client – or any individual — to feel their
feelings in a direct bodily way. This in turn enables them to sense
whether their words or actions are in resonance with their own immediate
somatic sense of their own situation or state of being.
Soma-sensitivity training
draws from Gendlin’s method of Focusing but shifts its focus from
exploring the factors which enable clients to benefit from
therapy, to the factors which enable therapists and counsellors to be
successful — irrespective of the particular approach they adopt. Rather
than examining and comparing the different models and methods,
strategies and skills, processes and procedures which different schools
of therapy employ, it concentrates on the dimensions of awareness that
make individual therapists successful – in particular their own bodily
self-awareness and sensitivity to the body of the client. The
practical focus of soma-psychology is not on the client’s
‘pathology’ and its ‘causes’ but on the soma-sensitivity of the mental
health professional — their sensitivity to the felt body and bodily self
of the client. Soma-sensitivity training for mental health professionals
has already been shown to bring rapid benefits in their work with
individuals suffering from psychoses, personality and anxiety disorders,
and depression. Its aim is to cultivate the therapist’s ability
to use ‘bodily sensing’ to (a) check out the efficacy of their own
therapeutic interventions, (b) to become more sensitive to somatic
dimensions of the client’s self-experience, and (c) use their own felt
body to resonate with and transform the client’s inner
bodily sense of self.
As Gendlin has pointed out, ‘therapy’ itself is best understood not as some
‘thing’ that one person is trained to ‘give’ to another, but as a
process — one that can either be facilitated or hindered in any
relationship, including the ‘therapeutic relationship’. The therapeutic
value of soma-sensitivity comes from its focus on the relational
significance of ‘bodily sensing’. Like Focusing, its benefits aren’t
restricted to the sphere of counselling and psychotherapy but can be
experienced in all human relationships. More specifically,
soma-sensitivity training is relevant to the relationships between all
types of mental health professionals and their clients. It offers a
valuable new form of complementary training and continued professional
development for all those working in the mental health field — one that
not only has its own direct therapeutic value, but also offers important
new theoretical insights into the very meaning of ‘mental’ illness.
Training in soma-sensitivity is not a substitute for established bodies
of professional knowledge. What it provides is a way of preventing the
latter from being mechanically applied — helping the individual mental
health professional to ground the concepts and techniques they apply in
bodily sensing and to cultivate their own somatic sensitivity to the
client. Only in this way can particular approaches to the treatment of
mental disorders cease to be reliant on a set of pre-established
‘processes’ and ‘procedures’, ‘skills’ and ‘strategies’. For if the
incidence of somatic symptomology, drug abuse, violence and wilful
bodily self-harm in the client population can tell us anything, it
is that such ‘difficult’ clients refuse to be reduced to a set of
disembodied cognitive processes or behaviours.
The
Principles of Soma-psychology
Soma-psychology differentiates itself from other forms of body-oriented
psychotherapy or ‘bodywork therapy’ by clearly distinguishing the
individual’s physical body from their own inwardly sensed body or ‘felt
body’. It recognises the inwardly sensed body as an independent ‘inner
body’ in its own right. Used as a medium of psychotherapy,
soma-sensitivity is a form of inner bodywork in the most literal
sense. Inner bodywork is the use of the therapist’s own inner body to
feel and transform the client’s inner bodily sense of self, and to
deepen the client’s inner bodily sense of connectedness to others. The
basic principles of soma-psychology can be summed up as follows:
1. The less aware we are of our body as a whole, the less aware we are of our self as a whole. The more aware we are of our bodies, the more aware we are of ourselves.
2. The inwardly sensed body or inner body is our link to our inwardly sensed self or inner self, and to the inwardly sensed body and self of others.
3. Inner body awareness is awareness of an inner body. The inner body is a body of awareness — the bodily shape and tone of an individual’s self-awareness.
4. Each individual’s physical body language has a more or less limited alphabet of movements, facial expressions and vocal tones.
5. The more restricted an individual’s body language is, the less able they are to embody their own inner body states.
6. Inner body states that cannot be fully embodied find expression as mental-emotional states or somatic symptoms.
7. Emotions are motions of awareness in the inner body. Feeling ‘low’ or ‘down’ for example, is a motion of awareness toward the lower region of the inner body.
8. The mind is itself a layer of the inwardly sensed body, a language skin or “ego skin” which functions as an internal mirror reflecting inner body states.
9. Psychological metaphors such as ‘closed off’, ‘thin-skinned’, ‘hard to stomach’, ‘cold-hearted’, ‘hurt’ etc. are literal references to inner body states.
10. Our own inwardly sensed body and self is a medium of inner-body resonance with the inner bodily states of others and their inner bodily sense of self.
Soma-psychology transcends the artificial separation of physical and
‘mental’ illness in somatic medicine and psychotherapy. Physical body
functions such as respiration, digestion and metabolism are the
expression of basic functions of our inner body – for example our
capacity to inhale, digest and metabolise our awareness of the
world and other people. Both physical and mental illness are the
expression of inner body states. Physical illness is the expression of
disturbed inner-body functions – the respiration, circulation, digestion
and metabolism of awareness. So-called ‘mental’ illness is an expression
of a disturbed relation to the inwardly sensed body and self. This
disturbed relation however, is invariably felt both as a self state and
as an inner body state. States of anxiety, depression,
dissociation or depersonalisation for example are all felt in a bodily
way and in this way affect the individual’s bodily sense of self.
Specific psychiatric disorders such as schizophrenia, depression,
bipolar disorder, borderline personality disorder express specific
disturbances in the individual’s relation to their inner body and inner
self. What is regarded in the West as the ‘disease’ of ‘depression’ for
example, (a word with no equivalent in Japanese) can be understood as
the expression of a culturally induced incapacity to actively depress
awareness from the head and upper regions of the inwardly sensed body to
the abdomen and lower body. For it is in this way that we reground
and recentre our inner bodily self-awareness, restoring a
healthy sense of what Winnicott called “psycho-somatic indwelling”.
Schizophrenia, on the other hand, is the expression of a split between
the inwardly sensed body or psyche-soma (Winnicott) and the inner
space of our minds or mind-psyche. Soma-psychology has an
intrinsic cultural and spiritual dimension. For as the Japanese
philosopher Sato Tsuji pointed out: “It is the great error of Western
philosophers that they always regard the human body intellectually, from
the outside, as though it were not indissolubly a part of the active
self.”
Viewed
from the outside, self and body are both seen as something bounded by
our own skins, and separated from others by an empty space filled only
by air. But there is a deep reason why the root meaning of the Greek
word psyche and pneuma meant ‘breath’ and ‘wind’, and why the
words ‘spirit’ and ‘respiration’ have a common derivation from the Latin
spirare – to breath. For in what manner and at what point does
the air we breathe in become a part of ‘us’ and ‘our’ body? And at what
point or in what manner does the air we breathe out cease to be part of
‘us’ and ‘our’ body? The question cannot be answered except by
suspending our ordinary notion of self and bodyhood. Our inner bodily
sense of self has no physical boundaries but is an awareness
that, like the air we inhale and exhale, also flows between us
and the world. The deep connection between awareness and breathing was
well recognised in the spiritual traditions of the East, where
meditation meant centering both awareness and breathing in the abdomen
rather than the chest. Individuals in our globalised Western culture, on
the other hand, tend to be identified almost entirely with their heads
and upper bodies. Not being grounded in lower body awareness,
individuals lack a sense of inner centeredness. Both their
breathing and awareness are disconnected from the abdomen, that abode of
the soul which in Japanese culture has always been understood as both
the physical and spiritual centre of gravity of the human being.
In Greek culture the word soma originally referred simply to a lifeless
corpse devoid of psyche or ‘life-breath’. Only later did the word
soma come to refer to the living body of the human being, and the
word psyche to its sensed interiority or ‘soul-space’. Today the
very term psychology has become a contradiction in terms,
referring to a ‘science’ in which soul or psyche has no place, or
in which it is identified with the mind or brain. Its connection with
the individual’s inwardly sensed body is completely ignored. Only in the
work of Winnicott do we find a recognition that mental health has to do
with the psyche-soma as opposed to the mind-psyche — our
capacity to dwell and feel at home not just in the mind-space of our
heads but the inner ‘soul space’ of our bodies.
Soma-Sensitivity and Somatic Resonance
What
body is it with which we feel ‘warmer’ or ‘cooler’, ‘closer’ or more
‘distant’ to someone – independently of our physical temperature and
physical distance from them? What body are we referring to when
we speak of being ‘touched’ by someone without any physical contact, of
moving ‘closer’ to them or ‘distancing’ ourselves from them, of feeling
‘uplifted’ or ‘carried away’? Are these phrases merely emotional
metaphors derived from motions in physical space, or are the emotions
themselves expressions of basic motions of awareness belonging to
an inner body of awareness – that ‘soul body’ which Winnicott referred
to as the psyche-soma, and Jung as the ‘subtle body’? What body
and what organs are we referring to when we speak of someone being
‘warm-hearted’ or ‘heartless’, ‘thick-skinned’ or ‘thin-skinned’,
‘stable’ or ‘unstable’, ‘balanced’ or ‘imbalanced’, ‘solid’ or
‘mercurial’, ‘stable’ or ‘volatile’? Are we simply using organic or
bodily ‘metaphors’ to describe disembodied mental or emotional states?
Or are we describing felt states of the inner body – the
individual’s subjectively sensed body.
The
practice of soma-psychology is dependent on the practitioner’s own
soma-sensitivity and their capacity for somatic resonance. This is the
capacity to resonate with another person’s mental-emotional states and
‘feelings’ in a bodily way, as felt states and motions of their inner
bodily self-awareness. Again it must be emphasised that when we speak of
someone feeling ‘fragmented’, ‘frozen’ in panic, ‘hollow’ or ‘empty’
inside, walled in ‘up to the neck’, ‘volatile’ or about to ‘burst’ etc.
these are not simply emotional metaphors but literal expressions of felt
inner body states. These felt states are also field states of
awareness which can be sensed as inner-body states through somatic
field resonance.
When we
see someone hunched up or laid back, smiling or frowning, laughing or
crying, then their posture or facial and voice expression not only gives
outer form to an inner tone of feeling, it also induces a similar
feeling tone in us through somatic field resonance. Somatic field
resonance is a resonance of outward form (morphe) and inner
feeling tone. In this sense it is the essence of what biologist Rupert
Sheldrake has called ‘morphic resonance’. The whole art of the
soma-psychologist lies in their ability to use their outward sensitivity
to the body of the patient to resonate with their inner body – with the
felt tone and texture, shape and substantiality, lightness and darkness,
density or diffuseness, spaciousness or narrowness of another person’s
own inwardly sensed body. Inner body states may be conveyed not only by
the body language of the other but by the inner resonances of
their verbal language. In particular, it is of great
importance for the soma-psychologist to listen for significant
somatic metaphors used by a patient, and to resonate with the inner
body states that may constitute the literal inner sense of these
metaphors.
The
Resonant Healing Process
Soma-psychology understands therapy as a resonant healing process
from soma-sensitivity to the words and body language of the
patient to somatic resonance with their inner body. Somatic field
resonance in turn is what facilitates a transformative response
on the part of the practitioner.
The
resonant healing process:
1. Soma-sensitivity
2. Somatic resonance
3. Transformative response
What I
call healing resonation is the capacity of the practitioner to
(a) sense and resonate with the patient’s felt bodily sense of
dis-ease, (b) transform their own inner body state from one of
dis-ease to one of ease, and (c) use somatic field-resonance to effect a
felt transformation in the inner body state of the patient. The
practitioner for example, may find themselves outwardly sensing and then
inwardly resonating with a quality of frozen immobility in the inner
body of the patient. Only by first resonating with this sense of
‘frozen immobility’ – feeling it in their own inner body — can
the practitioner begin to gradually transform their own inner
body state from one of ‘frozen immobility’ to one of ‘warm fluidity’ or
‘fluid warmth’ in contrast to the frozen immobility. The key word is
‘gradual’. For it is only through establishing and staying in
resonance with the patient’s inner body that the practitioner can (a)
use their own transformative response to exert a resonant healing effect
on the client’s dis-ease (b) sense the degree to which their own
transformative response is exerting such an effect. If it is not having
sufficient effect then the resonant healing process must be either
renewed or intensified at one or the other stage, for example by
renewing somatic resonance with the patient’s felt dis-ease, or gaining
a new and different somatic sense of it. Central to the art of
healing resonation is the practitioner’s awareness of the dyadic
field of awareness between practitioner and patient. If the practitioner
is successful in resonating with the patient’s felt dis-ease this
resonance will be experienced by both patient and practitioner as a
shift in the felt quality of the dyadic field. The practitioner’s
resonance with a particular quality of the patient’s felt sense of
dis-ease will automatically amplify the patient’s own inner
bodily awareness of it. At the same time it will automatically intensify
the field-resonance between practitioner and patient in a way
that is felt by both.
Medicine
and Soma-psychology
In
what relation do psychotherapists and ‘mental health’ professionals
stand to the medical model of illness, and in particular to the medical
treatment of somatic symptoms? The question is a politically charged
one, because the professional boundary between somatic medicine and
psychotherapy is one closely guarded by the medical establishment. Many
mental health professionals also still defer to medical authority and
the medical model, at least when it comes to so-called physical illness.
This is something of a paradox given that:
1. the majority of patients present to their local physicians with problems seen as ‘psychosomatic’ by the medical profession itself.
2. most physicians completely lack the professional training and skills to sense and resonate with the psychological dimensions of somatic disease (eg. the ‘loss of heart’ that may be experienced and expressed through physical heart symptoms).
Psychotherapists and mental health professionals of course, tend not to
be sought out by patients who see their symptoms as purely somatic, and
their ‘illness’ as something purely physical. Soma-psychology, on the
other hand, recognises not only a hidden psychological dimension to
somatic symptoms and physical illness but a hidden somatic dimension to
so-called psychological symptoms and ‘mental’ illness. Many people
recognise that the division between psychotherapy and somatic medicine,
mental and physical health, is an artificial one, maintained only by its
institutionalisation. Until now however, there has existed no framework
of thought that truly transcends the artificial separation of ‘mind’ and
‘body’, ‘psyche’ and ‘soma’ – not only in theory but in therapeutic
practice. Soma-psychology provides such a framework, acknowledging as it
does that the ‘soul’ or ‘psyche’ has its own independent bodily
dimension and exists as an independent inner body in its own right – the
psyche-soma. The theoretical principles of soma-psychology resonation
therefore provide keys to a fundamentally new understanding of
‘psychosomatics’. Similarly, the practice of soma-sensitivity, somatic
resonance and healing offer keys to a fundamentally new approach to both
psychosomatic therapy and ‘somatic psychotherapy’, both psychotherapy
and somatic medicine.
Bibliography:
Aron and
Anderson (ed.) Relational Perspectives on the Body Analytic Press
1998
Gendlin,
Eugene Focusing Bantam 1979
Gendlin,
Eugene Focusing-oriented Psychotherapy Guilford Press 1996
Mindell,
Arnold Working with the Dreaming Body Routledge 1985
Sheldrake,
Rupert Morphic Resonance - A New Science of Life Park
Street Press 1981
Wilberg,
Peter Heidegger, Medicine and ‘Scientific Method – The Unheeded
Message of the Zollikon Seminars New Gnosis Publications 2004
Wilberg,
Peter From Psycho-somatics to Soma-semiotics – Bodily Sensing
and the Sensed Body in Medicine and Psychotherapy New Gnosis
Publications 2004
Wilberg,
Peter The Qualia Revolution – From Quantum Physics to Cosmic Qualia
Science New Gnosis Publications 2004
Wilberg,
Peter The Therapist as Listener – Heidegger and the Missing Dimension
of Counselling and Psychotherapy Training
Winnicott,
Donald The Maturational Process and the Facilitating Environment
Hogarth 1965