Inside Body Therapy: Helpful or Problematic?
Ask Elklit, The University of Aarhus, Aarhus, Denmark
April 1, 2001
In the spring 2000 issue of Traumatic StressPoints, David Baldwin connects us with body therapies "online" in his article,"Connecting to Somatic Psychotherapy." This initiative opens up more information on which to base decisions of whether body therapy is warranted for a certain client with a specific problem.
In her introductory note to Baldwin's article, Traumatic StressPoints editor Elana Newman emphasizes that there is a great controversy about 1) the theory, ethics, practice and evidence regarding such body therapies; and 2) the position that the society should take with respect to this work. Web sites on body therapy often have the characteristic of being business in disguise: advertising and recruiting clients for therapy and professionals for training. In the Danish book Forløsning for choktraumer (Resolution of Shock Traumas, Copenhagen: Kreatik, 1993), one has the chance of diving deeper into and catching some of the essence of one influential school of body work, as co-workers from the "Bodynamic Institute" write about their trauma therapy with PTSD clients.
Getting the client to feel safe enough to treat and contain the shock, the therapist creates "the safe place," an image of a shelter where the client must go in order to get contact and care. The image must be an actual safe place where responsible and caring adults are present. Furthermore, in this therapy the client brings along contact persons, who serve as these actual adults.
A core element in shock trauma therapy is reestablishing the running reflex. This effect is obtained by making the client run continuously while lying on a mattress. After some practice of the technique and the "stop" mechanism (i.e., establishing contact with the present), the client talks about the shock. As soon as there are signs of anxiety, stiffness or numbness, the client must run to the safe place where he or she receives contact and care from the contact person. Subsequently, the orientation reflex is processed, and locked muscle tension patterns as well as inexpedient decisions are treated. The client returns with new tools to the shock event and starts all over again, or continues to relive the event. The work continues until the event can be relived without loss of memory and shock reactions.
The contact persons have specific tasks. They are witnesses who confirm the reality of the horrors. Furthermore, they have a symbolic role as a kind of new parent passing along relevant and true information about care and protection that the client has missed. In ordinary psychotherapy this role normally belongs to the therapist. However, Bodynamics believes that due to transference, it is best to separate the functions and avoid the massive transference often seen at crisis intervention.
My main objection to this line of body work is its metatheory: a victim did something wrong in a situation and, subsequently, through a repetitive process must practice to do it right: to run to a new fictive place where contact, understanding and care are available. The process is very well directed: by yelling a command, the therapist demands that the sometimes unwilling client either run or stop in order to relate to the present.
In my experience, locked reflexes and muscular tensions are not reestablished or released through gymnastic performances or by willpower, but by attention and contact. The Bodynamic School wants to replace the negative experience and the feeling that "there was no place to seek out" with a positive experience -- partly through the imagination of a safe place, partly through the participation of the contact person. However, the reality is that there was no help at the time.
The client finds this horrifying. In my experience, the healing comes when the client shares this experience with the therapist, who can contain it and react appropriately. The positive starting recollection, the ditto ending scene, the participation of the contact persons and the running technique are in my view not only unnecessary elements but also damaging elements because they are perceived as necessary (and consequently muddle the therapist's awareness) and become secondary victimization and victim blaming: "you did not do the right thing -- now I will teach you to do it." Teaching has replaced therapy.
Victims of infringements have a fierce anger and vengefulness in them, which is a power one must find. Bodynamics advises "to recognize, to treat and to integrate the polarity." However, the other pole in the polarity is not described. Through "a precise and bodily rooted reconstruction and reorganization, the event must be altered, so to speak, step by step, to what could have happened if it had not gone wrong." The Bodynamic technique is supposed to resolve two things: shock traumas that have a highly emotional charging -- e.g., violent assaults, sexual abuse and other traumatic events that occurred while the client was alone; and decisions made that had a crucial influence on the person's character structure. The work method is recommended as a sound treatment method resolving the PTSD-syndrome -- both mentally and physically, but this claim is not substantiated with any empirical documentation.
Ask Elklit is an associate professor in clinical psychology at the University of Aarhus in Denmark and is a licensed specialist in psychotherapy working mainly with torture victims and clients with personality disorders.