BODY PSYCHOTHERAPY WITH COUPLES: USING THE SEVEN DEVELOPMENTAL STAGES MODEL OF BODYNAMIC ANALYSIS
by Anne Isaacs, LCSW, and Joel Isaacs, Ph.D.
Recently one of us was asked to participate in a panel on body psychotherapy with couples that was focused around a hypothetical vignette. We would like to use this vignette and our response to it as an introduction to how we use our training as Bodynamic Analysts when we each work with couples. First we’ll give an overview, then say what we would scan for, and then discuss what our particular body psychotherapy perspective brings to this situation. We will then discuss the vignette and our response to it. Then we will present a case history that allows us to go into more practical detail about how we bring the client’s body into the psychotherapy.
Overview of working with couples
Our personal and professional experience is that we all want intimacy and we are all simultaneously ambivalent about it, at least at some level. Intimacy is wonderful, and it can also be very disturbing since it can bring up too many feelings, especially strong early ones. This polarity, this push-pull, this structural contradiction, this cosmic dance is what brings many couples to therapy. One cornerstone of our Bodynamic approach is the concept that a central aspect of human life is the seeking of what we call “mutual connection”. Most simply the “mutual” part is conveyed by the question “Can I be all of myself, and you be all of yourself, and can we still be connected in a caring way?”. It is our understanding that when there are stresses or breaks in mutual connection that the infant or child, in order to maintain or restore some connection, will distort himself in ways that lead to the patterns we see in adults. How these disturbances play out in later life is often the focus of our work with couples. Each person in a couple has qualities that the partner admires and would like for themselves. Often some of our deeper issues and stronger feelings may only arise when we get close to someone, when we are intimate. And, at these times, it is often difficult to separate one’s own issues from what is a reaction to the other person’s behavior. We keep in mind that the issues and feelings couples bring in may not be ones they are familiar with or can presently own.
If we broaden our vision for a moment to examine the social context in which couples operate, we can see that individuals in our society generally come together as a couple to find love, peace, security, and fulfillment, and often to raise a family. Of these, the most widely talked about is love. When we ask people what love is they often say love is a feeling, and it turns out to be a feeling that lacks a precise definition. But how is it that something so many people want can’t easily be described? Perhaps this is one source of the difficulty in obtaining it. We are seeking, sometimes desperately, a feeling that cannot be precisely defined. (But, “You’ll know it when you feel it”.) Sadly, this definition of love as a feeling is only one part of love, some of the time.
Love is not an instinct that rises up in us, and love is not an emotion. Feelings always come and go, and we would not normally make a long term commitment based on a feeling we know is temporary. Love encompasses acceptance, compassion, and empathy, and loving someone will help us to open our own heart. A fuller, deeper, more useful idea of love knows it as an act of will, a choice, a decision, a promise even. The practice of love is perhaps best understood as the will to extend oneself for the purpose of nurturing one’s own or another person’s spiritual growth. A loving relationship requires us to extend ourselves, to commit to open and honest expression and communication. It requires us to both show and expect: care, affection, respect, responsibility, commitment, and trust. Love is as love does.
How might a view of love as an action and an intention help individuals in a relationship or seeking one? They could begin by seeing loving as a practice of putting their partner’s interests on an equal footing with their own. They would understand that work and challenges will be involved if they are to maintain and deepen the connection made possible by their original connection. They might even come to see the appearance of difficulties as a possible sign that their relationship is maturing, for often, in the embrace of intimacy there is space for early wounds to surface. As therapists, we see this perspective as both helpful and motivational, both supportive and challenging, and we try to impart some of this vision to couples whenever we believe it is appropriate.
The initial session
In the initial session, we believe the couple’s first impression of their therapist is very important. Here they should be evaluating whether they feel seen and accepted. However, their evaluation of us will often have a component of each deciding “Whose side is he/she on”? Or, alternatively, out of fear of their own issues, they might find it safer to come together to reject us. So it is vital for each of the couple to have the experience of being heard and affirmed by the therapist. Secondarily, at whatever level they can take it in, it is of great value for each person to witness their partner being heard and affirmed. Perhaps they can begin to understand some of what the other needs, and to witness the relaxation and decrease in tension that can occur for the partner when they get it. This opens the door that separates their closed place of stuckness from the possibilities that lie outside.
There are many avenues that can be pursued at this point in the first session, and many of the initial impressions we get would go into making the choices. Often what they bring in may want some immediate attention. Sometimes an action or expression of one, or a dynamic between the two, will allow an entry to a core issue. Meanwhile, we try to assess their levels of commitment to each other and to the therapy process, their levels of intimacy and of self-awareness. We also try to assess each person’s ability to stay connected with their center, and their ability to maintain a boundary when in interaction. In the latter case we might suggest they explore changing the distance between their seats so that they might better sense themselves clearly. We might want to focus on one and then the other, or we might want to have them engage in a dialog. We might bring in some physical action, or we might decide to keep the session verbal.
A Bodynamic Analytic view
But let us now move on to what is more uniquely from our perspective as a Bodynamic Analysts. The Bodynamic System combines depth cognitive psychotherapy and an emphasis on relationship, with new research on the psychomotor development of children. The body is integrated into the therapy through our knowledge of the psychological function of each muscle. The resulting developmental understanding has been elaborated in a form usable by psychotherapists, a model of Seven Developmental Stages. This model is based on over twenty years of empirical research on how mind and body are connected. It contains a lot of specific information to be used as a guide. In work with couples, we would be very attuned to whether either or both persons were predominantly acting from one or perhaps two developmental stages. We would get clues towards this from their body structure and posture (e.g. as they walk in, how they sit), their energy and vocal style, their choice of words and phrases, and of course from the issues that they raise and how they present them (e.g., Macnaughton (1997). This information begins to direct our attention towards what we should suspect to be their underlying issues, and how we might respond to them. Their responses to our initial offerings tell us whether we are on the right track.
Let us devote a few pages to our character structure model of Seven Developmental Stages. A character structure model is a psychological description of a developmental stage, and a guide to how difficulties encountered in infancy and childhood may be carried over into the present and influence adult functioning. Character structure has some of its roots in Freud’s ideas about oral, anal, phallic, latency, and genital
stages, and was later developed by Erik Erikson. Wilhelm Reich (1949), a student of Freud, worked with Freud’s ideas and included more body characteristics for each stage. Further work from a body perspective was done by Alexander Lowen (1958, 1975) in the 50’s and 60’s . In these latter descriptions, character can be recognized from body posture and structure, as well as from attitudes, defenses, and issues presented in therapy. This early work sprang from the observation that when children are frustrated in an activity they may develop a chronic tension in their muscles to hold back that activity. Working from a complementary direction, Lisbeth Marcher (1992) and her colleagues realized that flaccid or under-elastic muscles correspond to impulses, insights, and skills that are mostly absent or only partially learned. This, they found, is the body counterpart of psychological resignation.
One contribution of Bodynamic Analysis was to extend the character model to later years by identifying seven discrete developmental stages. Subsequent empirical research at the Bodynamic Institute, Denmark, linked each muscle with its psychomotor task, and with the time in development when the muscle first comes under voluntary control. It is at this time that the elasticity of the muscle becomes imprinted (over-, under-, or normal elasticity). Since specific groups of muscles correspond to the developmental tasks of specific stages, it is possible to get an overall reading for each developmental stage. This led to the recognition that there are three possible positions for each stage, and led to a greater clarity in the description and characteristics for each stage (See Bernhardt and Isaacs, (2000)).
The seven developmental stages span the time from the second trimester of pregnancy through twelve years of age (Appendix 1, and Bernhardt et al, (1995, 1996)). Each stage has some time overlap with the stage just before and just after it. And each stage has a predominant theme, from which it gets its name: Existence, Need, Autonomy, Will, Love/Sexuality, Opinion Forming, and Solidarity/ Performance. If the infant or child’s experience of their holding environment during a given stage is “good enough”, they will emerge more or less with the resources appropriate to that stage (the “resourced position”). For example, the Will Stage, which spans 2 to 4 years of age, has a major theme that can be expressed by the question “Can I be focused, powerful, and expressive and still be loved and accepted in my family?” If the child’s experience is good enough, they will be in the resourced position, which we characterize as “assertive”. This child, and later this person, can use their abilities and power in appropriate ways.
If there are disruptions or disturbances to development that are severe, consistent, and/or early in that stage, the child will likely be in the “early position” for that stage. Very generally this means that not all of the resources to be learned here were acquired, and that the child will be prone to experience resignation around the themes appropriate to that stage. If we again look at the Will Stage, we see that the early position is called “self-sacrificing”. The child has learned that their strength was most welcomed when it was in the service of another person, usually a parent. A person operating from this position will often not know how to act appropriately in their own interest. Clients can be helped to awaken undeveloped impulses and skills, exactly the ones missing but needed for working through these specific developmental task. The therapist’s ability to recognize and work directly with this psychological resignation by building new ego resources can be transformative.
On the other hand, if there are disruptions or disturbances that are not too severe or consistent, or that occur later in the stage, then the child will likely be in the “later position” for that stage. Again, generally, this means that the child has more of the energy and resources from this stage, but will tend to be rigid, fixed, or repetitive in the relevant behaviors and attitudes. For the Will Stage this late position is called “judging”. A child or adult acting from this position will be holding back their own power and often be critical of others who show initiative. More generally, unless the unresolved issues from any stage are resolved at later developmental stages, during the teenage years, through life experience, or in therapy, the adult behavior will show aspects of these early or late position characterological patterns.
People in difficulty or under stress are very often acting from one, or in some cases two, character positions. When this (or these) positions are identified, we are often able to elucidate the underlying themes and issues more clearly and directly. One of the lovely advantages of using this model with couples is that there exist well known clashes leading to specific dynamics between people who are acting from certain positions. Thus, by, addressing the issues of one person we can often simultaneously be working with the interpersonal dynamics of the couple. Because of the specificity of the Bodynamic model, and our ability to use a person’s body awareness along with simple movements to help bring forth the psychodynamics involved in most issues, we do not generally rely on exercises to do this.
Jenny burst into my office followed by Sam who followed her to the couch. Speaking quickly she described their long term relationship and how it was way past time for them to get married and have children. He appeared to be slowly sinking into the couch as she spoke. When I asked how he was with all of this he replied slowly that he didn’t see any reason to rush this and why was she always in such as hurry. Her level of anxiety increased visibly as she heard this. By the time he was finished, she was sitting on the edge of her seat ready to spring. He looked very calm by contrast with his legs outstretched heavily sunk into the couch.
Applying our model to the vignette.
At first “glance” Jenny and Sam each seem to be coming, at least partly, from the earliest developmental stage. This stage, named the Existence level, is, in our view, where the fetus and infant determines whether or not the world is a welcoming, friendly, loving place (Lake (1966, 1970)). Since this stage is so early, its theme is very broad, and at the same time the means to deal with the environment are the least developed. Thus the infant’s responses to a less than friendly environment are potentially the most drastic. If the environment is judged to not be welcoming enough, then the major protective mechanism available involves energetically splitting the mind-body unity into very different, polar positions.
A person acting from the early position, we name it the Mental Existence position, has a predominantly mental view of the world. This position, especially in its extremes (and under stress), is characterized by a strong detachment from the world, an introversion, and a commitment anxiety. The other polarity is the Emotional Existence position. This position, especially in its extremes (and under stress), is characterized by a strong separation anxiety, an extroversion, and a compulsive need for contact. In our scenario Jenny seems to be coming at least partly from the Emotional position, and Sam from the Mental position. Sam is also showing some characteristics of the early Autonomy position, that is characterized by non-verbal activity changing. Not being in touch with their own impulses and desires, a person acting from this position will often slow things down in order to not be swept up in another persons choices. So these would be our starting assumptions and we would be checking continuously to affirm whether they are valid, and to what extent. If our interventions help an individual or a couple to feel seen, contacted, or understood, if they enliven or calm a person or help them come forward in a new way, then we are probably on the right track. If this is not the case, we let go of the initial hypothesis and use the new clues we are getting to form another one. Let’s assume for now that our assessments above about Sam and Jenny are roughly correct.
When first listening to Sam and Jenny we would look for opportunities to affirm the qualities that led them to have a long term relationship. And given the state Sam and Jenny are presently in, we would not overdo this. People showing the Mental and Emotional positions can be very attractive to each other, each having some of what the other is lacking. For example the Mental is often seemingly very self-contained, and the Emotional seemingly very alive and in contact with the world. And we can see how this can lead to a negative feedback loop under stress, when Jenny strains for attachment and Sam for detachment. So, in session we would try to give Jenny the emotional contact we believe she needs and wants. We would also try be very concrete and factual in exchanges with her. By contrast, while making some contact with Sam, we would also give him lots of space. We would first try to meet him at an abstract level, and talk about his ideas of what is going on between them. If this is successful we would edge towards exploring his impulses and feelings.
Whenever we sense or perceive something going on with Sam we would draw his attention to the sensation in his body or a specific part of his body. In this way we would hope to help him contact what he is feeling, along with what he is thinking. If he passively resists something Jenny or the therapist say, we would try to help him discover his own feelings or ideas beneath this. We would look for opportunities to be supportive, first verbally, and as appropriate, by either asking him to put tension in the muscles that correspond to support for this developmental stage, or by stimulating the muscle ourselves (See Appendix 2). In general, we understand that a person in the earlier position in any stage needs more support, while a person in the later stage, having more energy and resources from that stage can accept more challenge.
By contrast, with Jenny we would affirm her feelings and make contact with her at an emotional level. We would begin to show her and teach her ways to contain her feelings, which seem to have a strong effect on Sam and sometimes might overwhelm her also. We would help her to center so that her feelings would be more connected to her thoughts. This could be approached either by having her bring her awareness to her inner abdominal area, or by asking her to put some tension into the muscles we have determined relate to centering (Bernhardt and Isaacs (2000)). When we had done these things, and when emotional contact was made, wherever appropriate we would help her to understand the reasoning behind her feelings and follow the reasoning to its conclusions, being aware that sometimes this might be fear provoking (and therefore ordinarily avoided). We would pay attention to clarifying the feelings and thoughts contained in any of her expressions that were metaphorical, because the latter can be a source of confusion to herself and misunderstanding with her partner.
As some of the tension between Sam and Jenny softened, and where appropriate, when giving contact to one (or contact with space to the other) we would turn to the other partner and ask how it is for them when their partner asks them for connection (or space). In this way we would hope to help each person begin to sense how it is for the other when they try to get what they hope for and so desperately want. Here, without naming it, we have begun to work with the dynamic between them that is likely most problematic. As we connect the past (character structure) with the present (feelings, attitudes, issues, dynamics) we are forming an implicit trajectory leading into the future. Couples can begin to sense new possibilities opening to them as they have new experiences and acquire new resources related to the issues and conflicts they are facing. In general, we try to allow issues to resolve by using our knowledge to hold the issue in focus. It is our experience that this leads to greater resolution, both in mind and body, and to fuller integration into people’s lives.
There are many ways to use the body to help individuals and couples experience, witness, explore, understand, and change their behavior. Often the focus will be on one person of the couple, but we regularly have them do some physical activity together. We will outline below some of the general approaches we use. In most cases we use the body to explore an issue that is already present in therapy. Whether and when we touch or do not touch a specific client is discussed in Appendix 3.
By simply bringing a person’s attention to their body, particularly to the physical sensations in some part of their body, they can:
Move from talking about something to an experience related to it.
Move from feelings related to the past to an experience of the present.
Move from the abstract level, from ideas or metaphors, to the concrete.
To help a person experience or express something more fully or deeply, we can:
Ask them to perform a movement that we believe will support or amplify their expression or experience.
Give physical support with a hand on their back. The exact placement of our hand will reflect our assessment of the character position being explored.
Stimulate a muscle related to the age or issue being explored, in order to help the latent psychological content flow into expression through words, expressive movement, or emotion.
When working with an early character position, where a particular resource may be weak or absent, we might want to help a client have a new experience. By working with the muscles relevant to the issue being worked on, you can help a person to:
Strengthen their boundaries.
Learn to contain a feeling.
Learn to ground themselves. When the new resource is embodied, it can be particularly empowering for the client to “revisit” the issue that stimulated the work.
When working with a couple it is often useful to have the partner of the person you have been focusing on see and sense the changes in expression, posture, voice, energy, and attitude of the other. One partner can also mirror the other to get a sense of what their experience is. The couple can move further apart and closer together to explore boundary issues. Often a simple holding of hands, or a hand used for support will prove very useful. Eye contact, at appropriate times, can also be very powerful.
An example of our work
It will help us to be more specific if we relate some actual work that one of us did. A couple in their early thirties had been married for seven years and had two children. They came in because he had an emotional outburst and could not contain it. She got scared and started getting physical by pushing him. I tried to help them understand the interaction by slowing down the story, and going through the interaction step by step. One of the ways I do this is to help each person sense what is going on in their body as they remember and talk about the incident. As they get in touch with their body sensation, they are more able to identify the emotions and impulses that were acted out in the original incident. He had gotten upset because she did not know where some money was. This pushed him back into feeling like he was once again in his disorganized family of origin. There, he had feared everything would collapse, and in the recent interaction he got very agitated and started yelling and screaming to hide his vulnerability and fear. She had felt shamed by his angry criticism, but that did not consciously register. The next thing she knew she was pushing him. As we talked abut it, she got in touch with her shame. In our discussion we decided we needed to work to help him contain his acting-out impulses, and to slow things down so he could become aware of what was underneath. She wanted help to set clearer boundaries and limits as to how much she will allow this behavior to be directed at her. She also needed support to counter her tendency to feel bad when something like this happens, and to assume it was her fault.
Looking at this from a characterological perspective we would be suspecting that she is acting from the Will structure, and from the early position of that structure. We call this the “self-sacrificing” position. Her feelings of shame and her assuming guilt are some of the indications here. We could also make this assessment visually from the structure and posture of her body. The origins of this structure in her life will become clearer later. His case is interesting because he is moving between two structures that are in conflict with each other. Normally he is also in the Will structure, but in the late position. We call this the “judging” position. In this position a person wants to contain all of their feelings. But under stress he jumps to the late Existence (Emotional) position. This position is characterized by lots of emotional expression, hence the conflict. He uses the late Will as a defense against even sensing the Emotional underneath, and this makes it very difficult for him to accept himself.
Here are some examples of how this material came to be worked on in later sessions. After another occasion at home where she broke out in a sweat when he wanted her to take care of something and she did not know how to manage it, we agreed to look at her tendency to collapse into shame and anxiety. She was the oldest of several children and her mom had died when she was not yet five. She had felt the responsibility to take care of the family and keep it together at that time, and felt overwhelmed by the responsibility. As we were talking about it, she started to feel overwhelmed. As she was starting to collapse in her spine, I thought it appropriate to give her physical support (See Appendix 3). I sat on the floor about a foot behind her and asked her to lean back until she was just off balance, and then to catch herself, paying attention to how this felt in her body. I had her do this a few times, and then asked her if it would be okay for me to catch her and help her next time. She agreed, and I caught her with both hands against the latissimus dorsi muscles (these are the broad muscles that wrap the back from below the shoulder blades to the waist, and act to pull the upper arm back ). I supported her in that place and then slowly pushed her back to a relaxed sitting position. I chose this particular muscle to support because it’s psychomotor function is self-support in the developmental stage she was acting from, and it also corresponded to the age when she lost her mother.
At first it was hard for her to allow my help and support. She became concerned that her weight would be too much for me, or that she would feel weak if she allowed herself to do this. We talked about these responses, and after a few times, she could let me catch her, support her, and bring her back to a balanced position. Then she started to feel a change in her body. She started to relax, and both sensed in her body and realized how much effort she puts into her holding herself together. I kept my hands on her latissimus and we talked about how support feels to her.
She then started to talk more about her mom’s death, and I asked her to remember that time and how it felt in the house, how she felt with the relatives who were there, and how her siblings looked. Then I asked her to put herself in the picture and notice how small she was. Throughout this time I was giving firm support to the latissimus muscles, at the pressure she said felt good. I started to talk to her as someone should have talked to her then, saying “Someone should have explained to you that you were just a little girl, and that your Mom had just died. And you needed support to be sad and grieve, and to mourn the loss of your mom. You needed to be taken care of”. At this point her shoulders started to relax and she started to feel a lot of sensation in her legs and feet. (We relate this to being more embodied and more grounded.) She stayed with that and I continued to talk to her as if she were that four year old, to speak to her from that developmental stage when this had occurred. She said “It seems as if a cloud is lifting from my head”, and started to cry. As the sensation in her head continued to change we sat there a bit more with the support to the latissimus. Then, when that felt complete, I asked her to again sit on the couch. I showed her how to put a bit of tension in the latissimus as a way of supporting herself, and for now also placed a pillow behind her in the latissimus area. I asked her to remember what had occurred the night before, when she broke out in a sweat. From a clear place she looked at her husband and said “I can be OK even when I don’t know something”. Her husband said he was very moved by watching this work she had done, and felt compassion for the struggle she experiences when he gets critical. What was remarkable to him was how similar they both were in their history, even though their ways of managing stress were different.
In another session, when they came in he was very agitated and unable to relax. He was disturbed by a medical report he had received, and was feeling distressed. He had been lashing out at her, was critical of her, and could not contain his own anxiety. We started to talk about what it was like as he was growing up. In his family there was a lot of neglect, a lack of boundaries. Two of the kids in his family were actually abused or molested by family friends. While talking about this, he became very agitated. There was much tension in his jaw, his talking sped up, and his shoulders and neck tensed. While talking about the lack of sexual boundaries in his childhood he made a very spontaneous but quick motion with his arms, as if in a fight. I asked him to slow that down and pay attention to the movement, to follow it where it might want to go. The movement developed to a full extension of his arms, as if he were pushing something away. He started to feel his own body more, all the way down to his pelvis. He remembered a memory he had of being a child and lying in bed, wondering if the family friend would come into the room. I suggested that as a child he could not protect his own body and was not able to push away the unwanted advances of the abuser. His response to stress then was to get very agitated and vigilant, or to disassociate. I asked him to stand and do the spontaneous movement again. Standing helped him to feel the support of the ground through his legs and feet. I gave a little resistance with my hands, so he had something to push against. He could sense his own power and stay present. We then talked about how he could not push away as a child, and instead got overwhelmed with agitation and stopped feeling his body.
I had the couple both stand and asked her to give him a little resistance and do a slow push hands movement with each other. She was able to really see how useful this movement was in helping him slow down, get into his body, and be more organized and coherent in himself. I suggested they try this out at home whenever he is feeling overwhelmed, and he was eager to do that. At the end of the session he was able to go through the medical information and start to talk about it without being overwhelmed. They felt closer to each other, first because the partner’s vulnerability was available, and also because they again saw how similar they both were.
In our work with couples we try to help people to see their partner’s defensive system (character patterns) as a defensive system – that they are using it to defend themselves against their own fears and feelings, and not to hurt the partner. This can most easily be grasped when one partner sees the other partner being vulnerable. The safety and containment of the therapy room makes this more possible. When people have experienced each other’s vulnerability they become more willing to make agreements with each other to help each come out of their defensive postures. Of course, working out exactly how to do this is best done when they are not in the midst of it. By bringing the body into the therapy, a kind of intimacy is re-established between the two. The use of non-verbal techniques is a way to introduce movement into stuck patterns, and many of the skills learned in therapy can be done together outside. As the couple are able to accept their differences in handling feelings and situations they also become more self-accepting, and this will lead them to be less stuck in their problems and patterns.
Bernhardt, Peter; and Isaacs, Joel (2000), The Bodymap: A precise diagnostic tool for psychotherapy. Bioenergetic Analysis 11(1), 111-140.
Bernhardt, Peter; Bentzen, Marianne; and Isaacs, Joel (1995, 1996), Waking the body ego, Part 1 and Part 2. Energy and Character 26(1), 27(1), 27 (2).
Lake, Frank (1966), Clinical Theology. London. (no longer in print).
Lake, Frank: (late 1970´s) Studies in constricted confusion (Exploration of a Pre- and Perinatal Paradigm). The Clinical Theology Association, Nottingham, England
Lowen, Alexander (1958), The language of the body, Collier Books, and (1975) Bioenergetics, Penguin Books.
Macnaughton, Ian (1997), The narrative of the body-mind. Embodying the Mind and Minding the Body, 22-34. Ed. I. Macnaughton, Integral Press, N. Vancouver, BC. (A number of the recent articles cited here are contained in this edited collection.)
Marcher, Lisbeth (1992), See, for example: Bernhardt, P. Individuation, mutual connection, and the body’s resources. Pre- and Peri-Natal Psychology Journal 6(4), 1992.
Reich, Wilhelm (1949), Character Analysis. See 3rd Edition, NY Orgone Institute Press
STANCE IN LIFE: Existential position; stance towards life; poise for action. personal stance; standing on one’s own; position on values and norms; orienting (keeping or loosing one’s head).
CENTERING: Filling out (from the inside); being oneself in one’s different roles; feelings of self worth.
BOUNDARIES: Boundaries of personal space (energetic boundaries); self assertion(making space for oneself in social contact).
GROUNDING AND REALITY TESTING: Ability to stand one’s ground, feel rooted and supported by it; relationship to reality; relationship to spirituality.
SOCIAL BALANCES: Balancing one’s own needs/feelings/desires against others’ expectations; balance of pulling oneself together/letting go; balance of facade versus openness in interactions; balancing being oneself with being a group member; balance of managing stress and resolving it.
COGNITIVE SKILLS: Orienting cognitive grasp; understanding (getting something well enough to stand forth with it); grasp of reality; ability to apply cognitive understanding to different situations; planning; contemplation/consideration.
ENERGY MANAGEMENT: Building charge, containment and discharge; emotional management; stress management; self containment; perception and mastery of one’s own sensuality
SELF EXPRESSION: Assertion; asserting oneself in one’s roles; forward impetus and sense of direction.
INTERPERSONAL SKILLS: Patterns of closeness and distancing; reaching out, gripping and holding on; drawing towards oneself and holding close; receiving and giving from one’s core; pushing away (saying no) and holding at a distance; releasing, letting go.
APPENDIX 3. ON TOUCH
The subject of touch in therapy remains controversial. On the one side we know that deprivation of touch in infancy can lead to severe personality disorders. On the other side, we fear that the client could be unduly provoked, or even exploited by the therapist. Without trying to go deeply into this area (e.g., Macnaughton (1997)), we can say that all of the instances where we use touch are carefully considered. First, we always use a “bounded” touch, so that our own energy is contained. We do not try to do any healing. We are usually either giving support to a muscle or having a person become aware of that muscle. Second we are careful whom we touch, and will generally not do so with people having character disorders, e.g., borderlines and narcissists. Then, we ask permission before touching, say how and where we intend to touch, and give the person the instruction to ask us to stop anytime they are not comfortable with the touch, or are even unsure they are comfortable. We do not touch if we have any concerns about how an individual might experience it, or if we have any concerns in ourselves, whether clear or unclear.
If we decide that it is not appropriate to use touch with a particular client there are still several ways to bring the body into the psychotherapy. A first way would be to have a person focus on body awareness and sensation. The second possibility would be to teach the person how to use the specific muscles related to the issue they were working on. If we suspected the muscles were underelastic, corresponding to missing resources, we would have the person tense them. If we thought the muscles were overelastic, corresponding to a rigid or held back ability, we would ask the person to stretch them. These respective actions help the historical attitudes and experiences of the issue being worked on to flow into awareness. A third possibility, and this would be subject to our assessment of the couple, and to their negotiating an agreement each time, would be to have the partner provide the touch. In this latter case we would then teach the partner exactly how to give the touch.