CHAPTER 1
ISP's Guiding Assumptions, Concepts and Values
Basic Assumptions
The most fundamental assumption of ISP is that people have all the resources they need to heal and grow. The major issue that individuals face is gaining fuller access to their potential. The development of character structure leads to a limiting of resources that are available to the individual. ISP focuses on this important task of expanding access to a person's broader potential.
Opportunities are supported, created or sometimes given to patients to help them make fuller contact with their resources. First, the person's attention is expanded to include their body sensations. In addition, their breath is deepened, raising their consciousness of their inner experiences. Touch work elicits patient experiences that are often related to early traumas. Spontaneous movement is elicited and supported, which often surfaces deeper aspects of the self, new ways of looking at their experience, and new behavioral capabilities. Dream work deepens self-perception and opens persons up to novel perspectives about themselves. These are some examples of how ISP enhances access to inner resources.
The Therapeutic Relationship
This is a complex area in body psychotherapy. We can only cover some of the highlights in this overview.
The therapist usually intervenes early in sessions to increase the energy level and self-awareness of the patient. This enables the patient to play an important part in structuring their session and, ultimately, the course of their psychotherapy.
The ISP therapist responds empathically to the here-and-now experience of the patient. The therapist also helps to deepen this experience by fostering a fuller awareness of the experience as well as the greater meaning that the experience has for the patient. Often, for example, experiences that occur together do so because the patient sees their meanings as related to each other. The therapist deepens the self-awareness of character by stimulating her patient by using touch work, the expansion of spontaneous movement etc. She helps the patient to identify the basic themes that these experiences reflect, the recurring assumptions they are based upon, their etiology, and the basic somatic underpinnings of these experiences.
Thus the therapist supports the patient to look at the pattern of the experiences the patient has been exploring. This helps the patient to develop broader perspectives of herself. This additive process of connecting experiences into patterns is called induction; this is the primary approach of ISP.
In contrast to the inductive approach, the use of character theory to intervene to elucidate other aspects of a character that have not emerged yet is called deduction. Character theory connects overt behavior with implicit processes that occur in the unconscious. The theory of character types prepares the therapist to look for the other aspects of the character that are not yet conscious to the patient, and character theory is used to structure interventions to make the unconscious process conscious. Using theory to link conscious behavior with unconscious events is referred as deduction (vs. induction). Here the therapist uses theory to determine the course of the therapy. This is more the psychoanalytic approach.
Another important facet of the relationship is the establishment of an extremely safe treatment space in its spatial and psychological aspects. The former includes a physically safe environment for the patient to actively express intense emotions without harming himself or the therapist. Mattresses and cushions are deployed to make the office safer. Rugs have a deep, soft cushioning underneath. Sound insulation is used on the walls, doors and ceiling. White sound may be used to mask the patient's sounds. The person can make as much sound as needed without being concerned about being overheard or disturbing others.
As I mentioned previously, psychologically the therapist supports the patient to express any fantasy, feeling, thought or action short of harming himself, the therapist or destroying office equipment. It is important to implement these limits because they parallel limits that often occur outside the therapy relationships in life's situations. And effective psychotherapy is a process that helps patients to deal more with the realities of their world. At the same time, the patient's thoughts, feelings and actions are accepted without judgment (and with support) by the therapist. This great degree of freedom of expression is crucial to the conduct of ISP.
The therapeutic relationship I am describing can be an extremely challenging one for a therapist to foster and sustain. At times, the emotional, mental, spiritual, and even physical demands on the therapist can be significant. It is essential that psychotherapists practicing ISP develop trust in themselves and courage. Psychotherapists develop self-trust and courage, by engaging in their own personal ISP psychotherapy, in order to support a patient's fullest expression of their self.
The concept of the holding environment was applied to describing what the psychoanalyst seeks to achieve in the psychotherapeutic setting*. The analyst approximates the mother's holding by paying close attention to the patients' experiences, needs, feelings much as a mother does to her infant child. The analyst may also help the patient to arrive at their own insights or meanings for their experiences. The patient's dreams, fantasies, wishes and intense feelings are accepted and the therapist supports the patient's deeper exploration. The analyst also responds with empathy to these patient expressions.
All of these relational statements refer to ways in which the psychoanalyst may symbolically create a holding environment during a treatment session. This environment supports the patient in regressing back to earlier times in his life when he encountered trauma and his psychosocial development was not yet very established. This regression provides the patient with an opportunity to have corrective emotional experiences and to more fully integrate these earlier events into his psyche.
ISP uses all of these symbolic ways of creating a holding environment much as a psychoanalyst may do. Importantly, as ISP therapists, we also provide direct soft touch and containing touch to patients with our hands and bodies where this early bonding with the mother was insufficient. This type of intervention is extremely healing because it is a very powerful, concrete way of providing a corrective emotional experience!
ISP is Holistic
Human experience can be separated conceptually into two major aspects, the somatic and the psychological. This analytic separation is useful because using both viewpoints helps us to formulate a broader range of interventions. This increases the power of the psychotherapy. In contrast, traditional psychotherapy deals mostly with the psychological.
Reich (1949) wrote: "... Language as well as the perception of other's behavior renders the respective physiological state unconsciously, not only figuratively, but in an immediate manner". For example, analytic experience shows that if somebody is called "inaccessible" and "hard," he is also muscularly hypertonic or armored. If patients feel themselves to be "slimy" or "dirty," analysis shows that their character contains major anal elements.
A therapist can generate body interventions that are simple and very effective. One person I dealt with had a dropped shoulder. I asked him to breathe deeply and to exaggerate this drop in his shoulder. He became aware that he was holding himself back from developing his life fully. Then I had him exaggerate his rounded shoulders. As he exaggerated his rounded shoulders, he got into deep mourning of the death of a very close family member. His incomplete mourning was holding him back in his life. I had him see his family member, and talk out-loud about what he needs to say to him. Notice how simple these interventions are, and how productive they can be for the person. This sequence also demonstrates that somatic events can be the embodiment of psychological processes.
The co-occurrence of the somatic and psychological takes place in fundamental and dynamically important ways. Thus, a person who has developed an assumption that the world is an unsafe place and that she is likely to be attacked unpredictably (especially from behind) may protectively develop massive chronic tension in her back muscles.
As the above example shows, assumptions are built into the structure of the body. People who feel burdened may develop shoulders that are very tight and are held high to "shoulder their load". This body characteristic can be used to further the therapist's diagnostic understanding of the patient.
The therapist can also use somatic interventions to directly help the patient to become aware of these issues and to explore them in depth. The ISP practitioner uses deep touch that is hard and then soft to the muscles of the shoulders and neck to start releasing their armoring. Body psychotherapists pay attention to occurrences at the psychological and somatic levels and move back and forth fluidly to intervene at both levels.
For example, I have had patients whose lower jaw is thrust forward. This often signals willfulness and a determination that is very often exercised even when it is unneeded and inappropriate. This is an example of how character gives rise to inflexible behavior. I used deep pressure on the jaw muscles' spasticity to soften them. As these muscles softened, forgotten earlier experiences and attendant emotions frequently came into patients' consciousness. I promoted a full expression of these dammed up feelings and then I supported an identification of the existential issues embedded in these experiences.
The patient benefits in a major way when she becomes aware of her rigid exercising of excessive, willful determination. I use the loosening of the jaw muscles as one benchmark for the progress of this work.
Similarly, I had a middle-aged male patient who already showed primarily masochistic and oral aspects. His name was Steve*. One prominent body symptom was that he had recurring sciatica. No Chiropractic treatment had been fully successful. The symptoms abated and then got intense again. During a session, I had Steve pay attention to his inner experience and breathe deeply. Then I asked him to experiment with moving his body in ways that felt right and to continue to breathe deeply. (I started with a minimally structured intervention, knowing that if nothing significant emerged, I could follow-up by asking him to explore movement in his pelvis.)
I asked Steve to notice what he experienced as he moved. He ended up rolling his pelvis in a circle repeatedly. Steve had an image emerge of the inside of his pelvis being a garage that was unfinished on the inside (it had no wallboard).
During the next several sessions Steve returned to this movement and to this unfinished garage image. First, he realized it had to do with his father leaving his mother and abandoning him at the age of one. This thought emerged suddenly. His father had no further contact with Steve after he left. In this session and subsequent ones, Steve got into intense feelings and expressed anger and rage at his father for abandoning him. He saw his father on the mattress before him and beat him on the mattress until he was exhausted. After several sessions of expressing his anger, he suddenly shifted to mourning his father's leaving. He had deep feelings of sadness. After this part of his therapy, Steve's sciatic pain disappeared and did not recur during the course of his psychotherapy and beyond.
Energy Phenomena
Reich identified a crucial aspect of the person — bioenergy — that is highly useful in mind-body work. Bioenergy is a longitudinal flow of energy, which moves from the front of the pelvis, up towards the head and then down from the back of the head to the back of the pelvis. This energy also moves from the front of the pelvis down towards the feet, and then returns to the pelvis via the backs of the legs. When the energy flows in the front of the trunk, softer feelings like love, trust and fear are experienced. By contrast, the flow of energy in the back of the body involves harder feelings of anger and aggression.
Bioenergy is a crucial concept that has a dual occurrence at both somatic and psychological levels. As a body process, it involves movement of energy both at the surface of the body and more deeply at the level of blood flow and nerve conduction. (Nerves are closely associated physiologically with the vascular system. During embryonic life, nerves grow along the "lanes" created by blood vessels, assuring nerves of the plentiful supply of blood that they need to function.)
The psychological aspect of this energy flow as it intensifies, is the experience of feeling more emotionally alive, animated, resolute, active and engaged. This energy is more accurately named psychobiological energy, and I will refer to it as such in this book.
This increased freedom of energy flow and heightened vitality is supported by the looseness of attendant muscles (versus the chronic spasticity of these muscles, which choke off the energy flow). In addition, the person's level of metabolism is affected by the fullness of breathing so that the oxygenation of the blood and body tissue is maximal. All these aforementioned factors suggest specific body interventions that can be used to increase energy, if this is needed. For example, I have helped patients increase the vital capacity of their breathing by placing my hands on their ribs and pushing as they exhale while they are in a supine position (more about this later). As their rib cage opens up and their breath deepens, their energy level increases markedly, and their ability to recover unconscious memories is enhanced.
Armoring
Threatening situations trigger people to defend their integrity by mobilizing their ego mechanisms of defense. This is more likely to happen when individuals are young children and their repertoire of protective behavior is limited; therefore, they resort to mechanisms of defense, such as, repression, denial, projection, reaction-formation and undoing.
Defenses distort a person's perceptions of reality — this is a cost. At the same time these defenses can be usefully protective — and this, of course, is a gain. When these ominous situations are direr and are experienced as life threatening, the child feels terriffied, freezes and dissociates. In these latter situations, we identify the child as being traumatized.
The somatic processes of dissociation and ego mechanisms of defense are similar in many ways. Usually the person curtails their breathing during these processes. Muscles are tightened that are related to movements that might be a part of flight or fight reactions to extremely threatening situations.
As an example, if their parent is abusing them as a child, and the child's reaction is to run away, and the parent forbids this movement by physical threats, the child may well tighten the muscles in his legs. This helps him not to run and to avoid the additional trauma of being beaten. If the child is repeatedly threatened in this same manner, these muscles in the legs become chronically hypertonic. This chronic hyper-tonicity was called armoring by Reich.
Candace Pert (Pert 97) has played an essential research role in studying the place of the body in cognitive processes. Led by an initial interest in neuropeptides, ligands and receptor cells, Pert conceptualized that decisions about which memories become conscious and which are relegated to the unconscious is influenced at the cell receptor level throughout the body. Thus cognitive process is not confined to the central nervous system. The memories that do not become conscious are stored in the muscles. Pert's concepts of cognitive process occurring throughout the body and the storage of unconscious memories in the muscles support ISP concepts and interventions rather directly.
Armoring — which, in essence, is the process that Pert is describing, in which unconscious memories are stored in the musculature of the body — occurs in segments or hoops in the body. There are seven segments: the eyes, mouth, throat, chest, diaphragm, stomach and pelvis (the legs are seen as an extension of the pelvis).
As muscles tighten to form these constricting hoops, the flow of psychobioenergy is impeded; this is what armoring achieves. In many people, the flow of energy is so hampered that it is mostly stopped and there is no awareness of the armoring. This is parallel to how ego mechanisms of defense operate. The person is also unaware of the ego mechanisms of defense. The flow of energy is only felt when the energy level is increased dramatically by physically challenging activity and/or intense emotion.
