Embodied Approaches to Psychotherapy

In this presentation, Julianne Appel-Opper describes a theoretical foundation which is a contemporary blend of relational body-oriented psychotherapy, with roots in Dialogical Gestalt and intersubjective psychoanalytical thinking, and she invites you to consider psychotherapy as an embodied process. The talk explores how clients bring their pre-verbal implicit relational knowledge into our consulting rooms and how it is with their bodies that they broadcast their attachment histories. As therapists, we inevitably and physically react to these embodied narratives. They reach us skin-to-skin, heart-to-heart and muscle-to-muscle, stimulating responses and impulses in reply. She proposes that the subtle physical impulses of the therapist as a bodily being – and how we receive and reply to those messages as bodily sensations – is at the core of the work. Illustrated with three illuminating cases.

Video lecture with transcript – 28 mins

Julianne Appel-Opper supervises Jon Sletvold

Here, Julianne works with Jon to demonstrate a relational body-psychotherapy approach. Jon talks about his work with someone with whom he feels unable to create a developing connection. In the course of this supervision, by examining his embodied emotions as he thinks about this patient, he gradually comes to a place where he grasps the complex defences that may be blocking intimacy between them. Finally, he knows what it is that he needs to say to his patient, and experiences a sense of calm and liberation.

Video supervision – 32 mins

This conversation provides a personal and historical accounting of the gradual reconciliation and integration of somatically-based and psychoanalytic approaches in in-depth psychotherapy. In his talk, Bill Cornell illustrates how the attitudes and techniques of each tradition can deepen and enhance the other. Drawing upon the work of Wilhelm Reich, Donald Winnicott, Christopher Bollas, Muriel Dimen, and Ruth Stein among others, Bill argues for the centrality of one’s body and sexuality in our psychic realities and interpersonal relations. He further argues for the place and function of informed touch as a means of facilitating sensorimotor awareness and nonverbal communication.

Video lecture with slide – 54 mins

In this presentation Morit speaks about the role of the body in trauma work and present her integrative embodied model. She demonstrate how neuroscience, rather than prescribing some kind of objectifying therapeutic technique, informs her own self-awareness, and helps her regulate and hold her own bodymind process as it absorbs the client’s dissociated trauma and participates in its enactment. Awareness of the bodies and the implicit communication between them deepens her relational sensitivity, exposure and involvement and thus the intersubjective connection. Morit describes how the client’s sense of isolation as trapped within the trauma and at the mercy of it can only be healed through relationship with a therapist who is capable of putting her own bodymind on the line. She proposes that surviving, on both somatic and psychological levels, the identification with all the figures involved in the traumatisation, is what qualifies the therapist as safe enough to become the regulatory object.

Video lecture with transcript – 35 mins

Touch, Empathy and Sexuality in working with Trauma

Video interview – 13 mins

Following a brief history of Sensorimotor Psychotherapy (SP), which initially drew upon a range of body modalities – movement therapy, postural and structural integration, yoga and Hakomi – Dr Pat Ogden explains how SP works in in the treatment of those who have experienced trauma or attachment distress. First and foremost, within SP trauma is looked upon an experience which first and primarily effects the body and nervous system. Animal survival responses are activated at the time of trauma before cognitive or narrative areas of the brain react. However, often these instinctual defences – such as the desire to run or fight – are unfulfilled, leaving the client with a habitual sense of unease. We think of completing these physiological and somatic responses in therapy, letting the wisdom and intelligence of the body lead the way and thus working with the client’s embodied memory of trauma via “bottom-up” processing. Therapeutic work lies in resolving the enduring effects of the original traumas, rather than the memory itself, and in helping people change how they inhabit their bodies so that the experience more integration physically and psychologically. Even if patients cannot talk with you, Pat Ogden says, changing how they live in their body is in itself is both possible and deeply therapeutic.

Audio lecture with slides – 33 mins

In this interview, Susie Orbach explains how her focus on the bodily-self arose from her project of theorising the body as a developmental, relational phenomenon. She has reformulated Winnicott’s maxim, “There’s no such thing as a baby,” to “There’s no such thing as a body”. The body, as much as the self, is the outcome of relationship.

Furthermore, she argues that the parental/child relationship is one that occurs within a particular cultural moment which has impacted upon the parental body, which itself has been marked by geography, class, religion, gender and so on. This will be bequeathed to the developing child’s sense of her or his own body.The complexity of messages we receive from culture about what a body should be is leading to increasing confusion of identity in people’s search an integrated and stable bodily-self. Orbach talks about cosmetic surgery in all its forms as part of the search for safety rather than an act of self destruction. Whether it’s the person with anorectic behaviours or person who has had many cosmetic procedures, the search is for safety.

To illustrate her understanding of bodies in relationship, Orbach describes an adult patient with chronic colitis. This woman had experienced early disturbance as a baby who was unable to manage her feed, with a mother unable to receive her most basic bodily needs. In the countertransference, she describes how she came into a great contentment in her own body. The patient was able to use her as an external body for herself, and begin the process of deconstructing the defensive false body with which she was struggling. The goal of therapy, she suggests, is to develop a body, just as would aim to develop a psyche, and that the relationship is the means of doing so.

Video interview – 38 mins

In this experimental ’embodied interview’ Dr Asaf Rolef Ben-Shahar and Jane Ryan attempt to illustrate an interaction that focuses on the minutiae of embodied responses between two people, within a relational framework. As they reflect upon and communicate their experience of each other during the conversation they go beyond an intellectual explanation of embodied psychotherapy to an experiential encounter. A level of intimacy and honesty is quickly established, which exposes each of them to a degree of vulnerability in relation to each other. Themes of proximity, safety, wishes and fears between them quickly come to the surface. This video raises questions about the role of the body in relatedness, about real or therapeutic intimacy and the human need for connection.

Video interview – 53 mins

In this interview Yorai Sella focusses on the contribution of an integrated Psychoanalytical-East-West approach to embodied psychotherapeutic work. His claim is that contemporary, psychoanalytically informed psychotherapy implicitly recognizes a unified psyche-soma. It is also beginning to recognize ‘at-one-ment’ – the permeability, merger or interpenetration of the therapist’s and client’s psyche-soma. However, plagued by its Cartesian heritage, it is hard put to formulate, conceptualize and – above all – consistently implement these recognitions.

With Shoshi Asheri as interlocutor-participant, the interview demonstrates how current psychotherapeutic understanding and clinical knowhow may be guided by Zen and Daoist therapeutic paradigms. Innovative categories of potentiality, flux, vitality and disclosing-embodied expression are offered to circumvent the fissure between verbal and pre-verbal, presence and representation. The therapist’s presence is demonstrated to be both a guide to clinical practice and a potential curative agent in and of itself.

The interview ends with some radical implications of this unitary turn in body-mind relations in the field of public psychiatric health programmes

Video interview – 50 mins

This paper argues that the therapist’s own body forms the constitutional foundation of our capacity to experience and communicate in the therapeutic situation. The therapeutic process is seen as a continuous process of registering, feeling, sensing, what is happening and changing in the therapist’s body as s/he interacts with the patient – a process that largely proceeds beyond the bounds of conscious awareness. It is argued that therapeutic action is fundamentally dependent on the therapist’s ability and freedom to respond immediately – verbally and nonverbally – to the patient’s e-motions, actions and verbalisations. The importance of reflective thought is acknowledged, and is seen as resting on the analyst’s ability to gain awareness of unconscious bodily relational experiences. On the basis of these assumptions, it is suggested that training and supervision, in addition to its traditional emphasis on exchange of words, should focus on sensitising therapists to embodied experience and expression.

Video lecture with transcript – 35 mins

Jon Sletvold supervises Julianne Appel-Opper

In this brief supervision session, Jon helps Julianne to reach some new insights about a client who had experienced early neglect and trauma. This approach demonstrates the theory that, by supporting the therapist in imagining the client’s bodily experience, and by focusing closely on her bodily countertransference she will come closer to a third position of being able to overview the core themes of the therapy work that is needed. Jon’s approach combines Reichian psychoanalysis with contemporary relational body psychotherapy. Micro-observation of affect is at the core of their discussion.

Video supervision – 33 mins

This presentation addresses some of the recurring problems that arise when we attempt to re-include the body in the talking therapies. He outlines some of the shadow aspects and limitations of traditional Body Psychotherapy, which need to be processed before therapists from other traditions can usefully absorb body-oriented ways of working. Rather than using the body as a tool or technique to overcome resistance or minimise or circumvent the transference, he suggests we embrace a re-visioning of all therapeutic theories and techniques in the light of a non-dualistic conception of the bodymind, as envisioned by modern neuroscience. In order to fulfil the promise of bodymind integration he proposes that Body Psychotherapists need to re-integrate psychoanalytic understandings of unconscious processes and pay more attention to the relational space they offer. He outlines some ingredients of a holistic phenomenology of the therapeutic relationship, where attention to the client’s and the therapist’s bodymind deepens our engagement with the inevitable and necessary enactments of wounding dynamics which will occur, whatever our therapeutic approach to the challenge of characterological transformation.

Video lecture with slides – 45 mins

Many people agree that the mind is embodied and that there is no meaningful way to think of them as separate, but what – Katherin Stuaffer asks – does this mean in clinical practice? This presentation begins by examining what we understand by body-mind unity. She proposes that a developmental theory, in which the psychological growth of the child is inseparable from the process of gaining control and possession the body, offers much insight to the task of psychotherapy and that body sensation is a crucial component of any thought process. By elaborating the therapeutic advantages of this stance, she proposes that the client’s body can be used to regulate, deepen and contain material, particularly when that is rooted in trauma. Bodywork enables access pre-verbal material and extra fine attunement through somatic resonance. Case examples, and demonstration illustrate this talk.

Video lecture with slides – 57 mins

In this talk body psychotherapist Nick Totton argues that embodied relating is in fact the ground of all psychotherapy, including psychotherapy which sees itself as purely verbal; and that we can strengthen and enrich our work by re-construing concepts like transference and countertransference as embodied phenomena. He brings in evidence material from neuroscience, embodied cognitive science, and philosophy, together with clinical vignettes, and ends by suggesting how any psychotherapist can start to work with embodied relating in their practice.

Video lecture with slides – 44 mins