Thinking Through the Body

Biodynamic Massage
Biodynamic massage was developed by a Norwegian physiotherapist and psychologist, Gerda Boyesen. Even amongst the plethora of bodywork approaches that exist today (shiatsu, Feldendrais, polarity), biodynamic massage is fairly unique. Some of its techniques are based on Swedish massage, and it usually involves a massage couch, and direct skin to skin contact and manipulation. Nevertheless the word massage is misleading as well. Biodynamic massage is based on an in-depth awareness of the body as an embodiment of a psychological and energetic process. For further information on biodynamic massage, see www.ahbmt.demon.co.uk
Biodynamic Massage can be used as a treatment for stress, psychosomatic symptoms, or as an adjuct to psychotherapy.It can also be used by a body psychotherapist as a moduality within the therapeutic relationship.
Biodynamic massage has been developed further at Chiron, particularly in its attention to the psychotherapeutic relationship. Teaching biodynamic massage to trainee psychotherapists has given me a tremendous sense of its scope. Some practitioners are very skilled in perceiving and working with energy; others have a capacity to be firmly with the matter-of-fact side of biodynamic massage; some therapists are so attuned to the subtle changes in contact and relating that sooner or later massage techniques get in the way, and biodynamic massage as a way of working is put aside. There is a constant tension between the healing/treatment aspect of biodynamic massage and the process/relational side, which is a fundamental part of the richness and complexity of the work.
For details of training, visit www.chiron.org
Biodynamic massage is no longer a major resource in my work with body psychotherapy clients, though at times I still find it valuable. However, the experience I have gained from exploring biodynamic massage in a context of psychotherapy and training has enabled me to have an embodied sense of my philosophical and therapeutic position. My writing and research in the related fields of psychoanalysis and neuroscience has been informed and grounded by my study of biodynamic massage as a component of body psychotherapy. (see biography)

"Integrated muscular work" is a draft chapter for a teaching manual. "Verbal ways of working" is a handout written for Chiron biodynamic massage students. There are available here to give an indication of the teaching at Chiron - please do not reproduce without permission
Another article 'Mapping a Landscape: Massage in Psychotherapy' is on the Body Psychotherapy Page.
INTEGRATED MUSCULAR WORK
CONTENTS
Muscular Assessment
Presence, tonus, gesture
Energetic quality and breath
Differentiation and sensation

Deep Draining
Origins of Deep Draining
Massage: Classical Deep Draining

Theory of Deep Draining
Case example: uncovering a deeper vulnerability

The therapeutic challenge of deep draining
A change in the Climate

Massage: Modified Deep Draining


Massage: Hypotonus
Resistance work and movement
Lifting

Massage: Definition work

Principles of Working with Muscle




Integrated muscular work

Biodynamic muscle work is largely derived from what Boyesen learned from Aadel Bulow-Hansen and Lillemor Johnson, although she also contributed techniques for emptying muscle, and integrating it with tissue and harmonising energy through the different layers of the body, including bone, muscle, tissue, skin and aura in Energy Distribution (At Chiron, and in body psychotherapy generally- as I will outline in this chapter - there has been a shift in emphasis from breaking down armour, with the technique known as deep draining, to inviting a more differentiated awareness and tonus in the muscle. The various kinds of touch include stretching, squeezing, twanging, probing, stroking, emptying and holding the muscle. Each technique is part of the massage therapist's dialogue with the client, exploring responses in the energetic state of the client and their musculature.

Living people
are soft and tender.
Corpses are hard and stiff.
The ten thousand things,
the living grass, the trees,
are soft, pliant.
Dead, they're dry and brittle.
Tao Te Ching, transl. Le Guin

Assessment of Muscles/Motoric Ego
Presence, Tonus, Gesture
There are several aspects to assessing the client's musculature/motoric ego. In a general psychological way it is important to evaluate how aware they are of themselves,their feelings, of you, of matter of fact reality. Are they energetically coherent, fragmented, flowing, conflicted? What is your impression of their muscularity - are they heavily or lightly muscled, muscles pumped, squeezed, slack, stringy? Notice gesture, are there repeated gestures, a variety, or an absence of gesture? These offer clues to key themes. (For in-depth explanation of the term 'motoric ego' see my article on The New Anatomy page.

Energetic quality and breath
In biodynamic massage, technique is usually part diagnosis, part relating, and part responding to specific physiology and to the client as a whole. In considering the clients' muscles, I am palpating to discover the degree of tonus, and the energetic quality of the muscle. Is it hyper or hypo? bulky or thin? is it dry and stringy? or full and charged? is it surrounded by lots of tissue, or quite separated out, or glued in? As I probe or hold I am observing the client's breathing, is it shallow? deepening? and other autonomic responses, such as sweating or trembling.

"If the muscle is full or even swollen, warm to the touch, we say it is 'ripe'. Think of a peach." "And if its hard and stiff, is it a potato?"

Differentiation and sensation
I am also interested in the clients' experience or sense of the muscle. Touch helps heighten awareness, and with muscle, small movements can also increase awareness. By asking questions, I can gather how much the client has a differentiated sense of their body - can they feel much sensation in the muscle? if I ask them to do a small localized movement, can they isolate specific muscles or do the muscles seem glued together? Are they aware of particular feelings associated with a muscle or a movement?

When the massage therapist contacted the muscles around my shoulder, I wanted to push hard against her. When this movement was contained with minimal but sufficient resistance, I had streaming sensations in my arms....they became warm. ....By contrast, when she held my leg, anything other than a very light pressure felt invasive and threatening. It felt as if the muscles could only find themselves at all if they were touched lightly.....

Deep Draining
Origins of Deep Draining
Deep draining is based on the psychomotor therapy developed by the physiotherapist Aadel Bulow-Hansen, influenced and supported by Trygve Braatoy. Braatoy was a psychiatrist who trained with Reich, when he came to Norway in 1935, and believed that massage was an important addition to the psychoanalytic approach. The massage focussed on hypertonic muscles, but Bulow-Hansen found that it had no effect unless it was related to the client's breathing: "Bulow-Hansen's technique was so specific and methodical....and always aimed to release the spontaneous breath...she was constantly watching how the diaphragm worked" (Cl,1) The respiratory release was often accompanied by, or followed by, emotional outbursts, vegetative reactions, and memories of difficult or traumatic events.

As the patient gave up more and more of the bodily armour and their breathing became much freer, the capacity to surrender to spontaneous and involuntary movements increased greatly. Little by little sensations of warmth, of prickling in the skin, and of shuddering movements in the limbs and trunks began to integrate themselves into [...] reflexive movements of the whole body.(Kat, 165)
For insight into using massage in psychotherapy, see 'Mapping a Landscape: Massage and Psychotherapy'

Classical Deep Draining
Aim to loosen armour, to facilitate postural change, to deepen breathing, to release repressed feelings.
Use to soften character rigidity, to 'unblock' a therapeutic process which seems stuck, to liberate energy where it is held back, to disturb the client's defenses.
Technique shock impulses - squeezing or twanging - are given across the muscle fibres just before the in-breath. Wait for the breath, encourage expression.
Sequence The sequence is highly specific, muscle by muscle, challenge to the control of breathing, moving around the back between the primary respiratory muscles and accessory breathing muscles. It addresses holding patterns in muscles surrounding the spine, the sacrum and the scapulae. The sequence then continues with a focus on the segments: the legs, arms and chest, head and neck. The sequence can be varied in order to track a process or to focus on grounding or expression.

Theory of deep draining
Muscular tension and respiration are mutually restricting and mutually liberating.The shock impulse causes a 'mini startle-reflex', thus giving the body the opportunity to complete its response to a startle pattern which has become chronic - ie. to contract, and then let go fully, perhaps with the accompanying expressive response, a shout, crying, hitting, or kicking. The focus is on deepening breathing, particularly opening the abdominal respiration, since it is the restriction of breathing which enables the individual to hold back their feelings.

At the moment when the massage is beginning to dissolve the 'dynamically loaded' muscle tensions [.....] the diaphragm will begin to flutter. sometimes it will appear to 'labour', as if 'making up its mind' which way to go. Eventually a breath will work its way through, usually in a wave pattern that is new for this client. At other times a big breath will come through all of a suddent, more like a great gasp, and may be followed by shudders down through the entire body. (Equilibrium, 51)

The theory is that, with each shock impulse, the muscle will contract sharply, and then relax as it recovers, before contracting again but not to the chronically shortened state it was in before. This expansion invites more fluid back into the muscle, making it riper, softer, more alive and sometimes more painful

The long term effect of loosening the "incrustation", as Reich described armour, are changes in posture, concomitant with changes in muscle tension, expression of feelings and deeper breathing. Gerda Boyesen comments that she still considers deep draining to be "the most direct approach to effect radical postural changes". (BTN, 65) It is distinct from other forms of re-structuring through bodywork, such as Rolfing and Postural Integration, which manipulate and re-organise the connective tissue surrounding the muscles. (See Ida Rolf, Rolfing)

Deep draining also contrasts with other forms of bodywork in that it actively encourages expression - movement, sound, crying etc. This is integral to this massage which focuses on challenging and melting characterological defences. This technique is only ultimately effective if the feelings and ideas which caused the initial contraction are released and recognised. However, awareness can develop in stages and it is not only the drama of catharsis that signals a shift, but also the client's experience of subtler movements of energy and a deeper sense of connection to the body.

Case example: uncovering a deeper vulnerability
Initially I felt frustrated, I didn't want to do anything. Therapy feels like work - I never make it easy for myself, I said. 'Shall we make it easy?' the therapist joked, as I got on the massage table. When the therapist started work around my throat, I had images of quicksand. As the massage therapist put her hand under my back I was surprised by how deep she was going. It was painful, but I felt met by it. It seemed to contact my frustration. Tension on the left side seemed to dissolve, and I felt tingling down my body; the right side felt more defended. I became aware of the tightness of my jaw; I felt an animal sense of wanting to bite; I felt how much I held my disapproval and my disdain in the tension of the jaw. Then it changed suddenley. I felt a melting sensation around my mouth, and could imagine being a baby wanting to suck. I felt so open, I felt I could not tolerate the therapist doing the wrong thing now. But she stroked very gently around my face and down my body, heightening and spreading that soft, soft feeling. Afterwards I felt very grateful and peaceful, and wonderfully alive.

[
The client complained of having to work too hard in therapy. There was a quivering in the throat, especially in the sternocleidomastoid muscle, as she reported seeing images of quicksand. I decided not to pursue her associations to quicksand, which would mean her 'working'. I started by putting my hand under her back and twanging rapidly up the muscles of the spine, and going deep into the levator scapulae, which was tight with fear. She found it painful but breathed deeply into the process. As I worked on the muscles on the left side of the neck, she described a sense of expansion around the head. The right side, she noted, felt more closed. I felt the change in the energy around the head which she had described, the muscles had become sensitized and softened. I worked gently on the skin level now around the mouth, jaw, chin. The whole area felt so porous, like the energy field around a baby. I stroked the energy down over the chest and into the arms, and down over the hips to the legs. The legs felt rigid and thick, in contrast to the intense vulnerability around the head. She had not worked, nor stayed in the quicksand where her needs would be smothered; instead, she had let me loosen her defences, and allowed herself to open energetically and receive.
]

The therapeutic challenge of deep draining
Deep draining is by far the most technically demanding massage in the biodynamic repertoire. At Chiron it is no longer taught to students in training for the Biodynamic Massage Certificate, but only to psychotherapy students. The therapist needs to be able to locate the muscles quickly and to know and understand the sequence. It is important to observe the breathing response and other autonomic signals. But above all they need to be able to 'hold' the client with their presence, to know how far they can challenge, and how to respond to the client's reaction to the massage.

When Reich developed his technique of pinching or pressing on chronically contracted muscles, he was working as a psychoanalyst and watching closely for inhibited or feigned responses in the context of the relationship with him. One of his significant contributions to psychoanalysis was the understanding of the negative transference, when patients projected on to him feelings or attributes of significant early figures. When working on his patients' armour he expected and was able to receive the full impact of the patients' feelings towards him.

"a special kind of massage during which [there is an] analysis based on expressions of pain .....a technically controlled form of torture....."(Tot,75)

At the psychiatric clinic where Gerda Boyesen learned deep draining there was a definitive separation between the massage treatment and the psychiatric sessions, one was carried out by a physiotherapist, the other by a psychiatrist (there was some communication between them). Although later she trained biodynamic therapist to work with massage and a psychological process, she did not really re-integrate them. In particular she did not acknowledge or address the negative transference, which can be evoked in any massage process, but is easily triggered by deep draining.

In part this was possible because she managed to inspire in her clients and students a strong positive identification with the technique and its benefits. The biodynamic approach explicitly sides with the repressed impulses in the body. The therapist assumes a 'good parent' position encouraging 'healthy' self-expression and the setting of limits. So the massage therapist is alert to any embryonic expressive movements in the client, and encourages noises or words which help release feelings, giving permission for the client to assert themselves. The therapist invites the client to come out, to expand into the contact.

I was deep draining her back, and noticed her legs twitching. I invited her to turn over and went and held her feet, giving a bit of resistance. On an impulse I said, "these are your feet, your legs". She started kicking, and shouting, "get off!, get off me". I encouraged her protest, aware that these feelings were probably connected with her history of sexual abuse.

I also believe that the emphasis on vegetative release - the somatic rather than the expressive, ie. sweating, diahorrhea, skin rashes - was Boyesen's unconscious way of diverting some of the negative charge. Somatisation itself can be a normal part of a process - the 'healing crisis' is a phenomena of holistic treatment and psychotherapy - but intense, sustained somatisation is a symptom of an uncontained process. Boyesen comments on deep draining that its "effectiveness was also a contra-indication, since the changes could take place too rapidly. I heard of cases of acute pneumonia and inflammation of other organs, eg. glands, as a result of the treatment [at the Bulow-Hansen Institute]" (BTN, 65) She stopped working with deep draining until she had developed more supportive complementary techniques.

"The loosening of rigid muscular attitudes produced peculiar body sensations in the patient: involuntary trembling and twitching of the muscles, sensations of hot and cold, itching, the feeling of having pins and needles." (Kat 167f)

A Change in the climate
Deep draining was developed in a psychiatric hospital, where patients were contained by their psychiatrist and the institution. Reich saw his patients five times a week. Nowadays, when therapists in private practice are getting more borderline clients, the implications of such a powerful technique have to be considered more carefully. In extreme cases, it may push pre-psychotic or borderline clients beyond their capacity to cope, and even for clients with more internal structure, it can be construed as invasive or even abusive. Of course, all this depends not just on the technique but the therapist's whole stance towards the client and their therapeutic understanding of a process.

During deep draining the client reported tremendous energy flow up his back, neck, head and arms. He compared himself to a bottle, which was filling up with energy. He said that what I did for him was "huge", that I touched very deep inside him

When Boyesen came to London in the late 60's, there was a revolutionary atmosphere - it was a time of breaking down old structures and believing in the healing power of love and peace. The widespread cultural optimism about human potential, the sense of liberation and embracing radical change probably helped contain the cathartic processes which characterised encounter, primal therapy, psychodrama etc. Through the 80's, 90's and now at the beginning of the new millenium, we are more cautious. Bernd Eiden has commented on the shift in the kind of clients who come to Chiron. Clients with borderline and severe narcissistic structures are more common, so are clients with histories of abuse. There has been a considerable advance in understanding shock and trauma in body psychotherapy, and a recognition of the need to develop a more integrated, containing style of work.

I was doing some deep draining - there was peristalsis and some deep breaths, but I had the sense of invading her. And I said, "even though I can't see it, I feel as though you're trembling". She said there was a pain shooting up to her head and she had an image of a flashing light. And so I asked her, "how far would you let me go before you said 'stop!'?"

However, negative transference which is understood and handled appropriately can still work hand in hand with deep draining. Muscle armour develops out of a need to bind anxiety, and so it inevitably re-surfaces as the armour melts. The clash of needs and perceptions in the client can bring into awareness powerful unconscious dynamics, and thus facilitate release and integration. It is the therapist's fear of their own sadistic impulses which can limit their capacity to hold the client with their strong feelings and to evaluate how far their defences can be challenged. Often the client experiences a mixture of feelings, the original fear which inhibited expression, anger and sadness, plus the fierce desire to own and embody his or her impulses and feelings.

Deep draining can open a 'can of worms' ........but it can also awaken a deep joy, a feeling of being at one with the body, and an appreciation of being in it.

Modified Deep Draining
Aim to soften armour, to deepen breathing, to enhance awareness of muscles
Use to release and integrate feelings, to strengthen the motoric ego, boundaries, grounding.
Technique fewer shock impulses. Contact with the muscles is firm and deep but not overly provocative. May use stethoscope, and include emptying. Gentler pace.
Sequence may follow formal sequence or vary, emphasis on containing and grounding.

Modified deep draining does not press so directly towards loosening armour and it offers more containment where feelings may be overwhelming. Rather than focussing on provocation, there is more emphasis on integrating the charge as it builds up. The contact with the muscles is firm, and invites the client to feel his or her way of using muscle, for example, how the muscles are supporting or holding back. The therapist uses less shock impulses, and carefully monitors their effect on the system. He or she waits till the muscles relax before going in deeper. Holding, or a few membrane or hypotonic strokes may be included.

The metaphor of armour for hypertonic muscles can conceal another aspect of muscles, which is the tremendous resonance between muscles in the body. The body is like a stringed instrument. When I teach deep draining, I suggest the image of twanging a guitar string....

I had a client who loved deep draining, who always wanted more, and would say, 'go deeper, go deeper', but then I realised that he was actually afraid of contact, of stillness, of light touch. As he pulled me in deeper physically, he was running away inside, wanting me to find him, and yet afraid of being found.

Hypotonus
Hypotonus massage was developed by Lillemor Johnson, who was influenced by Drs Trygve Braatoy and Nic Waal. She criticised the techniques for dissolving muscle armour and pointed out the limitations and failures of focussing exclusively on hypertonic muscles. She pioneered techniques for working with underdeveloped or hypotonic muscles, which related to deficiencies in the individual's infantile environment. These deficiencies usually relate to lack of support, lack of attention, and/or major losses. They indicate a psychological collapse, which is palpable in the muscle which is flaccid and inelastic. Johnson perceived however that in hypotonic muscle were latent or remote qualities which could be nourished by gentle stimulus and attention to the breath.
Johnson describes a shy client with a closed mouth, crooked smile, and shifting gaze, "the respiration will be even, halting in the expiratory phase, indicating that anxiety is held back in the missing stage of expiration."

Aim to nourish underdeveloped muscle, to modify tonus, to encourage expansion through the breath
Use to build resources where there is collapse and resignation,
Technique stretching the muscle on the in-breath, stretching and squeezing tissue, structural stretch of back, legs, arms etc. Can combine with some lifting.
Sequence follows usual biodynamic sequence, may vary according to areas of need

Hyptonic massage works with subtle and light touch which serves to awaken and energize muscles that have resigned. Johnson drew attention to breaks in the natural breathing rhythm, as a way to pinpoint where expression is blocked. By staying attuned to the client's breathing wave, the massage therapist can encourage the breath to come into the muscle.

As he lay on his back, I lifted the head gently and stretched it with the in-breath. Then I stretched the arm, pulling it gently away from the socket - this time, his breath, when I invited it to extend a little longer, became staccato. I took hold of his hand, his breathing deepened and quietened. I began to lightly squeeze the slack muscles just underneath his arm - the breath quivered again. He said he was feeling disgust, and turn his head away from me. I asked what other feelings there were. His chest heaved into a sob, he said he was afraid to give in to his sadness.

Resistance work and movement
Resistance work is not a massage technique, but a bodywork intervention used to help the client connect to a sense of their own impulse. It may be incorporated into a massage in order to give some focus for the emotional/energetic charge building in the client. The massage therapist offers the client something to push against, usually by placing their hand against the client's foot, hand, shoulder etc. Sometimes this encourages the client who is inhibiting their force to get in touch with the desire to kick or push. For others, it offers an opportunity to express their anger, or the need for a boundary, in a concrete physical way.

In order to work with the body's spontaneous self-regulating process, the massage therapist needs to catch gestures which may give clues to the clients inner process. An inner sensation may become an impulse. A fist, a turn of the head, a facial expression, a movement of the leg are indications of a feeling coming to the surface.

"During a massage, if I see any sign of movement trying to emerge in the client, I would always try to encourage it, because my conviction is that this is going to liberate and express much more energy than would result from what I'm going to do with my hands." (Clover Southwell, AGM)

One major limitation of biodynamic massage is imposed by the table. It is possible to invite the client to sit, or get off the table and move, but it is not always appropriate, and there is a certain clumsiness, the client may need to put some clothes on. Particularly with muscle work, where so much of the dynamic of discovery emerges in spontaneous movement, massage is restricted by the fact that the client is lying down.

Lifting
During passive movement there is a heightened consciousness of muscular tensions around the joints, spatial relations, and feelings, especially if movements are slow and there are periods of stillness. If the client can allow a process of being held and moved, the nervous system can re-organise precisely because it permits all attention to be given to stimuli both internal and external.

Definition work
Definition work is developed from the braking techniques taught by Babette Rothschild in her Somatic Trauma Therapy Course. These techniques have been adapted for use in a massage context at Chiron. Definition work is very focussed and matter of fact, with the client quite active in the process.

Aim to build containment - strengthen the ego - by consciously toning the muscle.
Technique find muscle, palpate, bring clients awareness to it. Give minimum resistance to it - ie. opposing its function eg. for sternocleidomastoid therapist puts hand under chin and asks client to push down.(Alternatively the therapist may invite the client to turn their head, while a slight resistance to the movement is offered) It is important to tell client to contract muscle slowly, not to push or force anything, just enough so they can feel it in action. With the client, identify the point at which the muscle is working to just optimum degree - ie. the client has a sense of the function of the muscle and the feelings that it evokes, and feels contained with them.
Sequence there may be a clue about where to start from the client - eg. they can't feel their legs, feel nauseous, or they just have a sense they want to start with the arms, etc. Sometimes it is useful to do the opposing pair of muscles. The guide is the client's sense of what feels right.

This massage is designed to heighten body awareness and help reinforce positive choices. It requires the client to actively sense, evaluate and give clear feedback to the therapist. The therapist has to keep inviting the client to notice whether each movement makes them feel 'better' or 'worse'. Better usually means feeling more grounded and contained, and feeling the function of the muscle, a sense of control. 'Worse' usually is any symptom such as nausea, dizziness, discomfort. Clients also need to be encouraged not to overdo it, holding a contraction for twenty seconds may be enough. Less is more.

The definition work I received was slow, meticulous, painstaking - careful mapping of known and unknown territory. At the time, I underestimated the impact, the impressions/sensations have stayed with me, deepening in the following days.

In contrast to working with the expression of feelings, definition work is explicitly about containing - but not repressing - impulses by keeping movement small, and fine-tuning the amount of resistance given. This is ego-strengthening for the client in a number of ways: it tones the muscle, it is very specific, the client is explicitly asked to keep self-regulating - how does that feel? do you want to hold this for longer? shall I do the other side? It can be quite experimental - working out where to give minimal resistance - the client can feel which muscles are being used, can explore, make suggestions. There's lots of dialogue and invention. It can be a great relief for the client to discover how effective this is in containing feelings.

When mapping the deltoid and with me providing resistance on her mid-arm, she felt a surge of aggression , with a desire to sharply elbow me out of the way. With a smaller movement, and with me meeting with minimally required pressure, there was a marked spontaneous shift in her breathing, deepening from her belly, promoting a sense of well-being. It seemed to give her a sense of completion.


To take the body seriously
is to admit one can suffer
Tao te Ching


The therapist encouraged me to use her as an 'edge' against which my muscles could be identified and experienced, related to... I began to feel streamings.... stimulating and simultaneously relaxing my whole being....
Then came an insight. I could not receive massage before because I believed that if I yielded, relaxed, let go of my iron grip on myself, I would be unable to get up, recover, be strong, cope (JC)


Principles of working with muscle
1. In working for expression and release, the therapist needs to distinguish and discrimate between organic movements, and more mechanical gestures, which may be an attempt to please the therapist or a way of warding off spontaneous movements.

2. Pain is primarily linked with changes in tension in the muscles, and tender muscles are often those in which the tension is changing. Muscle that are stiff, and are not painful at all at the beginning of a massage, often become tender as they soften, a sign that the body and breathing are changing.

"muscle activity devoid of sensation does not lead to change" March55

3. The client may go into a very receptive mode, allowing themselves to let go; or there may be a conscious experiencing of their muscle in a new way; or there may be a more explicit process - exploring movement, feelings, memories or images. What is important is that you sense the client is present with you.

"experience is in the interaction between motor and sensory happenings" B.B. Cohen

4. Talking can be an avoidance, or a way of integrating a process. Often the client needs to be encouraged to find a language for what is happening, for describing sensation, and connecting it with feeling.

"The rhythm of focus from inner to outer experience created a containing space, which held contrasts and graduations of feeling."


VERBAL SKILLS FOR MASSAGE THERAPISTS


Note: These guidelines are not meant to imply that you need to talk a lot during a massage session.

Often, very little needs to be said. Verbal intervention should be used minimally and subtlely to keep some contact and check on the client's well-being. If the answers are congruent with the client's body language e.g the client says "I'm fine" and the breathing appears flowing and you have a sense of ease and peace, no more needs to be said.

If the client's respnse to a question is not congruent, e.g the client says "I'm really enjoying this" but you notice that the breathing is very shallow and the client's eyes are wide open and 'on guard', you need to sharpen your observations and begin to ask yourself what is happening. Don't rush in to asking questions or commenting. Its important to give the client space.

Verbal interventions include instructions, questions, reflections, suggestions.

Instructions. These are especially important with new clients who may be very anxious about what the're supposed to do. e.g "I'm just going to wash my hands. You can get undressed - leaving on your underwear - and get on to the table in between the sheets."

Questions.
Ask open-ended questions - eg. "how does this feel?" - unless you have a reason for wanting more specific information e.g "does this muscle on your arm here feel very tender?"

Its often best to start with an open-ended question but if your client answers in a very general neutral way, you may want to follow up with something more specific. On the other hand if you ask a lot of very specific questions, your client may feel they're being interrogated! It may be best to just ask one question which can be answered in various ways.

Content of questions
The broad categories of interest, in approximate order of intensity or charge are: thoughts,sensations, images, memories, feelings, relationship. You may ask a general question eg. what's happening? and the answers can contain one or a combination of the following.

Thoughts. "I'm thinking about work". Thoughts may be on the road to the feeling e.g the client may continue, "I had a row with my boss and I still feel angry.." Thoughts may be an avoidance of feelings, "I was just admiring the wallpaper", or revealing general anxiety.

Sensations. These are particularly important to encourage, and perhaps explore, when working with massage. For the client, noticing and describing sensations is vital in building embodied self- awareness. It can be a fresh way to get in touch with experience without going down familiar thought pathways. It can be a very subtle and safe way for the client to expand their vocabulary for their sense of themselves.
E.g.'s "how does this leg feel?", "is this painful?", "are you aware of how cold your feet are?" "does this pressure feel okay?" "is this comfortable?" "can you feel this muscle?" "does it feel tight?" etc

It can be helpful to bring the client's awareness to areas that are numb, or cut off - but be careful: you don't want to increase anxiety, or make the client feel judged.

Remember, particularly in British rather repressed and 'body-shy' society, people are not used to talking about body feelings and sensations. They may find your questions very strange! You may need to start with simple practical questions, "are you warm enough" so that they begin to feel that its okay to listen to their body, and that you care about their well-being.

When people do become aware of a sensation that is not numbness or pain, they may find this frightening, particularly if it is a feeling of aliveness, inner movement, etc such as tingling. As with any subject, your tone of voice can help convey gentle interest, acceptance and understanding.

Images.
For the more sophisticated client, when there is a sense of something stirring which they can't easily put into words, you can ask if they have an image. A certain proportion of people thrive on visual imagery, but again, its important that the client doesn't feel they have failed if they don't have an image. Sometimes visual imagery is a way of splitting off from what's happening in the body and it is a sign that the client is quite frightened. (There will be other signs of fear too, in the breathing etc) You have to consider, does the image resonate? can you find a connection between what is going on in the client's body and the imagery they are using? E.g "there is a bubble of tears around my heart" - this is an embodied image that is concrete and suggests feeling.

Memories

There may be an overlap between images and memories. The client may see a picture of themselves somewhere or they may be seeing from the perspective of then, e.g feeling small and looking up at an adult. Being in the observer position is slightly more detached and may be necessary to keep the feelings manageable.

Some memories are pleasant, some stir up conflicting feelings. Sometimes the client knows quite clearly that they are remembering. Sometimes its more like a dream - there is uncertainty - did this happen? It is important not to assume immediately that it is a memory. It is much more important to support the client in recognising the feeling content and giving that space.

Memories of Abuse
Sometimes people are frightened that memories of abuse are surfacing and they will ask, "do you believe me?" If the client's memory is very specific and has a context - you can indicate your acceptance of the client and your willingness to listen and try to understand. If the details are vague, it may be wiser just to confirm your trust in the client's feelings, eg. "I can see you are very frightened. I don't know what happened to you but I will support you in finding out".

The massage table is not the place to explore this kind of trauma unless you are very experienced. When a client is overwhelmed by fear, it is helpful to (a) get them upright - sitting on the table or on a chair (b) keep eye contact - this helps bring the client back into the present (c) keep them warm, covered and supported with blankets and cushions.

Recovering memories is not the objective of biodynamic massage - it is something that can happen in the process as the client becomes alive to their history as it has been preserved in their body. If the client has suffered major trauma, you need to consider whether massage is appropriate. Is the client in therapy? Has the therapist given permission for massage ? (You always need to obtain the therapist's consent before starting massage) What is the client's life situation? Will they be able to get enough support to hold them during an intense process?

When a body memory is emerging there may be strong internal conflict between the part that has kept it suppressed and the feeling which wants release and completion. It is at this point that verbal intervention is most valuable to support the client in making sense of what is going on. Clients can quickly re-bury feelings and memories without very clear external support and encouragement. You need to strike a balance between asking questions to gain information, perhaps feeding back what you see, and giving the client space to actually experience what's going on. Don't press for resolution and insight - remain open to all sources of information especially your own and the client's intutitions.

Feelings
You may become aware of the client's feelings rising by changes in their breathing, changes in colour (particularly the face), increased restlessness or increased stiffness. They may not be aware of these feelings - keep the questions open, and be aware of your tone.If the client is regressed, if there is a lot of sadness or fear, you will probably instinctively soften your voice. This may be reassuring for the client. However, it is still important to remain separate: if you find yourself too drawn in and involved, you will not be maintaing safety. It is possible to be gentle and matter of fact.

If the clients can allow and make sense of their feelings - ie. understand what they are connected to, the feelings may only need acknowledgement and space. If you are not sure what's going on, you can ask questions to help clarify. e.g if the client says "I'm remembering how unhappy I was a few years ago", you might ask, "are you feeling unhappy now?" , or you might ask them where the feeling is in the body. Notice whether your questions or comments are followed by signs of opening (more breath, more feeling, more contact) or closing down.(holding the breath, tightening muscles). (1)

Sometimes the best thing you can do is wait, stay present to what's going on in you, keep a contact with your hands. You can place your hands where you feel/see the conflict or charge, or in a place of support such as the lower back, or on the diaphragm (at the back), or, if the client is on their back, you might hold their feet (if there is fear and the client needs grounding), hold their hand, or place a hand behind the neck to create a bridge between head and body.

It is not possible to give a comprehensive guide to how to meet, contain, and support a feeling process here. It is something you learn throughout the training. In biodynamic terms there are considered to be two channels for feeling: the expressive route, which means encouraging the feeling to come out through tears, movement, kicking, making sounds, putting things into words; and 'melting', which is grounding the emotional charge by supporting the downward flow of energy and abdominal discharge through peristalsis. Clover Southwell explores the indications and contraindications for these approaches in depth in her article on equilibrium. (2) In working with clients where there is not a psychotherapy contract, it is best to aim for melting and relaxation. (3)

There is a third more psychodynamic option, particularly appropriate for working in a psychotherapy process, which can include both the above but which focuses more on containment through finding words, making connections, exploring the relationship. In this approach sessions might include more verbal work before and/or after getting on the table.

The therapeutic relationship
In biodynamic massage, the relationship between client and therapist is of paramount importance. The relationship always reveals something about the client's process and the therapist's process. It is never neutral. Everything that happens in the client's body is, at least partly, is a manifestation of that relationship. If the client is breathing shallowly, this is in relationship to you as the therapist. If you feel protective of, irritated by, uninterest in, the client, this is a reflection of the relationship between you. Hence the importance of the massage therapist being able to own their feelings, and recognize their typical patterns.

As a beginner, it may be difficult to take into account all the aspects of what is going on, especially when you are learning new techniques and just starting to find your way around a body. But it can be reassuring to know that everything that the client does or feels is not neccessarily a reflection of your skill, but has at least as much to do with their history and your presence.

It is not neccessary to do anything with this information or any information. Initially you just need to notice things, feel things, observe and ask yourself a few questions. If the relationship does not seem to be getting in the way of a process -e.g you are doing a membrane massage and the client is gradually relaxing - you do not need to do any more.

When the relationship appears to be affecting the client's ability to relax, express, or surrender to the process (sometimes described as "resistance"), then you need to reflect on what is happening. This is often the aspect of experience that the client is least aware of. It is not always appropriate to follow this up on a verbal level - it really depends on the nature of your contract with the client, their readiness or 'ripeness' to explore the relationship, their capacity to respond to and understand the nature of your questions or comments.It can be very intimidating if the client feels that the therapist is trying to "get at" something. Softly, softly may be the best approach, eg. do you feel you're getting what you need/want from me today?" However a client who is more therapeutically experienced might prefer a more direct question, e.g "how are you feeling with me right now?"

Reflections
These can cover any of the above categories, and make an alternative to asking questions. They need to give the client some information that can be usefully assimilated which they might not quite have noticed for themselves yet. eg. "your breathing has changed since I started working on your legs. How are you feeling as I work here?" By reflecting and then asking a question you are educating the client as to possible links between breathing and feeling etc. One or two such reflections in a session is plenty unless there is a strong process going on otherwise the client may feel judged, analysed, examined.

Suggestions
The occasional postive suggestion which gives the client permission to let go and be themselves can be valuable, especially with clients new to a process.. These should be simple, "feel your belly (or legs, or hands etc)", "notice what's happening...", "let yourself breathe", "allow yourself some space to let go". Such suggestions belong in the session when the client is very close to opening, relaxing etc and these offer the extra support needed. They are not appropriate when they go against the prevailing tone of the session, eg. if you sense hostility, you don't want to try and infer safety.


Resonant moments: when it all comes together.
The separating of experience into components, eg. focussing on the sensation, or on a past memory, or on a detail can be, ultimately, from a psychotherapeutic point of view, a way of managing overwhelming feeling. We have all developed strong protection from being fully open and conscious. When, as massage therapists, we work on the body, we work directly with that protection in its energetic and physiological form., |If we are connected to our feelings, and in addition we have the verbal skills to evoke and trace a process, we have very powerful tools. The bringing to awareness of all dimensions - feelings, memories, thoughts, sensations - in the context of a relationship in the present constitutes an intense experience which touches and changes both the client and the therapist.

There is a parallel between the connections the massage therapist makes on a body level - between limbs and trunk, between layers of tissue, between an awareness from inside and a sense of being contacted from outside - and the connection made in any theraeutic context, between client and therapist, past and present, words and meanings, feelings and thoughts etc. Connections are relationships and the more complete our relationships the more alive we are.

In using words as massage therapists the aim is to invite the client to be present with as much as is right and ripe for them in that moment, and no more. Massage is process oriented and not goal oriented. For one client, allowing a single deep sigh or a feeling more warmth in their feet can be a huge stride.





Notes
(1) In Body-centred Psychotherapy: The Hakomi Method (Liferhythm, Mendocino, 1990) Ron Kurtz gives lots of examples of phrases and indications of process when working with the body.
See also Dreambody and Working with the Dreaming Body (Routledge and Kegan, London1984 & 1985). Arnold Mindell explores imagery and bodywork, giving exampes of how to find meaning through amplification etc. In Palpatory Literacy Leon Chaitow gives an in-depth guide to discriminations in quality, tone and texture of muscles, tissue, skin etc

(2) Clover Southwell, "Biodynamic Massage as a Therapeutic Tool - the Concept of Equilibrium"

(3) In order to working professionally with clients you need: a Certificate in Biodynamic Massage from Chiron or CPD; to belong to a professional association such as AHBMT (Association of Holistic Biodynamic Massagr Therapists) or AMP (Association of Massage Practitioners); insurance; and supervision. Supervision supports you in making and maintaining suitable contracts with clients, appropriate to their needs, wants and your qualification and level of experience.


How Many Senses Have We?
This talk was given at the AGM of the Association of Holisitic Biodynamic Massage Therapists in October 1998. It assumes a working knowledge of Biodynamic Massage. The second part is a commentary on Fritjof Capra's Web of Life, where I explore the concept of feedback loops in relation to biodynamic massage. I would like to thank the transcribers Chris Redyk, Diane Chipperfield, and Lisa Schmidt once more for their help in transcribing the talk.
Chambers English Dictionary defines the word sense as : the faculty of receiving sensation, general or particular; immediate consciousness; inward feeling; impression; opinion; mental attitude; discernment; understanding; appreciation; [...] soundness of judgement; reasonableness; [...] meaning; interpretation.

I have not reproduced all the definitions the dictionary gives, but it is remarkable how broad and holistic the meaning of this word is. It is applied to sensation ("the faculty of receiving sensation"), feeling ("inward feeling"), intuition ("impression/ understanding") and thinking ("judgement, reasonableness [...] interpretation"). These correspond with Jung's four psychological functions, or modes of perceiving and processing information. The dictionary definition also implies both detail and globality ("general or particular"), the depth and the surface of things ("discernment/ meaning" and "impression"). It strives to do justice to the breadth of meaning of this word - its totalizing, encompassing, bodymind-revealing implications. 'Sense' - our senses - lies at the heart and root of perception, how we take in and process the world.

The First Five Senses
Traditionally, there are considered to be five senses. I want to briefy comment on these in relation to biodynamic massage. The word 'listening' (with the eyes, ears, hands and impulses), derives from the Old English word hlysnan, meaning 'to give ear or hearken'. It expresses the capacity to focus our senses consciously, with attention, with an intention. In our modern urban culture we are often unaware of actively using the senses to select and gather information, but in biodynamic massage the act of listening with all the senses comes to the fore. Hearing is how we gather information from sounds - the client's words, their tone of voice, bodily noises, especially peristalsis and the noise their breathing makes. I think of peristalsis as a language which I know intimately and am attuned to, but which I rarely translate consciously into words and concepts as I use it. After a decade of using the stethoscope my appreciation of its langage is anchored deeply in me, and influences how and where I massage, but is often not close to the surface of my consciousness.

Sight is the most privileged of the senses in Western culture - its high rating is evident in the importance we put on appearance. In biodynamic massage we have an alternative framework for looking at the body - we are not looking for its aesthetic merits or failings, but for how the person is embodied - the holding patterns of the muscles, the colour and texture of tissues, the way the parts of the body relate to each other and tell their stories. We use both our foveal and peripheral vision. Foveal vision is very focussed (the fovea is the centre of the back of the retina, the place where vision is sharpest), and initiates an active contracting of the eyes muscles. This can become habitual, like any other kind of holding, limiting the flexibility of vision. Peripheral vision refers to a broader softer focus, using the outer edges of the retina, and tends to be an underused capacity. Whereas as foveal vision can help us observe detail, peripheral vision gives us the impression of the whole, the overall perspective, in other words, the aura (whether we consciously 'see' it or not).

Two other senses that we may not use so much - obviously - are taste and smell. I just want to include these in the five senses, but you may get a funny taste in your mouth when you work with a client that is relevant. And I suspect that our sense of smell - 'smelling the client out' etc - is important as well but its not something I have researched. Aromatherapists, for example, develop a very acute sense of smell as a series of relationships or harmonies. I believe that any sense that is highly developed opens the doors to more subtle perception. ie. far beyond the physical.

And then we come to the fifth sense - that of touch. It is fairly explicit in massage that we are gaining information about our clients through touch. We're feeling the tone of the muscle, the texture of the tissue, the characteristics of the skin. As with the other senses, touch can be used more actively to focus, or more receptively to pick up finer layers. Light touch is like peripheral vision, it receives a more global impression. The ends of the fingertips are one of the most sensitive parts of the body with lots of nerve endings for picking up the subtle nuances. As we become experienced as massage therapists we learn to discriminate with extraordinary precision and knowledge the physical layers and energetic qualities of bone, muscle, tissue, fluid, skin. We develop our "palpatory literacy".

The Sixth and Seventh Senses
We have a sixth sense, now widely recognised by scientists, though not formally instated as a sense. It is proprioception - the capacity to know and feel what your body is doing, where it is in space, and what movements it is making. The body has various groups of receptors for measuring tension values, any change in the length of every muscle, as well as noting each joint position and changes in pressure in the body tissue. The state of rest or activity of the organs, glands, blood vessels and nerves is determined by special receptors called interoceptors. The vestibular mechanism, located in the inner ear, receives information from the proprioceptors, interoceptors and kinesthetic receptors throughout the body and from gravity, space and time. This vast amount of information is integrated to create an internal map of the body which is dynamic, dense and detailed. This three dimensional sensory picture creates a background depth which we experience as a sense of embodiment. The more access we have to all this information, the more resonant and coherent our body awareness, the more we can know ourselves and imagine others as having depth, complexity and substance.

Proprioception means 'to receive oneself'. The word kinaesthetic, which means to feel/sense movement is a related term. The importance of this sense has been almost completely overlooked in Western science until recently. However, it is central to the body psychotherapy tradition since it forms the basis of self-awareness. Noticing that the muscles between my shoulders are tensing, or that I have a spasm in my calf muscle, or that my jaw locks tight in certain situations are fundamental clues to what's going on in me emotionally. Above all, the focus of this sense perception is change, such as the minute alterations in muscle tension, or orientation of the head, or quickening of the pulse. In this context, the benefit of massage is to flood the system with rich totally up to date information about how the body is. (I'll return to this theme when I discuss the importance of feedback)

Proprioception plays a crucial role in learning a skill. As our hands learn and become familiar with certain massage techniques, we no longer have to think about the techniques themselves. The movements, the location of certain muscles, how much pressure to use - all this our hands 'know' from experience, recorded in proprioceptive memory. If someone asks you how to do something, it is common to have to 'do' the action before being able to describe in detail how it is done. (Think of teaching someone to drive.) I notice when I teach deep draining that I can usually put my finger straight on the muscle I want to find. Obviously I use visual clues, but in addition my hands are experienced in finding muscles. I have over the years repeatedly calibrated the depth and pressure I need, become familiar with the 'feel' of each muscle and its relationship to other muscles (this is a mixture of tactile and proprioceptive). And the muscles have poetry in them - the levator scapulae so tight and short and deep, the bulky mass of the gluteals, the fine fan of latisimus dorsi.....

I want to suggest that we have another sense, which I'll call resonance. This takes us beyond physiology into the realms of energy. Vibration exists throughout all forms of matter, energy and consciousness. It is a manifestation of rhythm, of pattern that I believe we perceive at a cellular level via resonance. Resonance is a sympathetic vibration (Greek: sym with pathos feeling) - you pick up the 'vibe' of an individual, a group, a place. It is a basic phenomena of groups of all sizes, from families to whole cultures. I remember being nearly Wembley Stadium an hour before the cup final - the buzz of excitement totally permeated the air. No-one could have been oblivious of it.

In physics there is a name for this phenomenon: rhythm entrainment. This is where two wave-forms of similar frequency "lock into phase" with each other, meaning that the waves oscillate together. This will happen, for example, if a number of grandfather clocks are wound up - even if they don't start out on the same beat, the pendulums will gradually harmonize with each other. In terms of human consciousness, rhythm entrainment is like being on the same wave-length, ie thinking/feeling along the same lines. I think this is one aspect of what happens when we get cued in to something in the client. We experience sensations, feelings or thoughts that are somehow directly connected with their present state. Of course, the opposite can happen too - dissonance, interference, irritation, misunderstanding - and can be equally illuminating.

Synaesthesia - the fusion of the senses
It is fascinating to consider the varieties of ways of knowing or apprehending the world around us. It is easy to forget that, in the first place, there is a grasping or receiving with the senses. At Chiron, the term energetic perception is often used, and I think is useful as a collective name for all these senses combined and working in concert.

Synaesthesia, on the other hand, is the name given to the overlapping and blending of the senses. Technically, it is the "subjective [ie. experiential] side of the capacity for cortical cross-modal translation between the patterns of the different senses". Examples of this usually given are quite striking, such as hearing colour, seeing sounds, feeling tastes etc. Neuroscientists have studied this as a rare or pathological experience, but as David Abram argues in The Spell of the Sensuous (New York, 1997), the body naturally transposes qualities from one sensory domain to into another, "our preconceptual experience [...] is inherently synaesthetic. [.....] This is not to deny that the senses are distinct modalities. It is to assert that they are divergent modalities of a single and unitary living body, that they are complementary powers evolved in complex interdependence with one another." [original italics] (p.60)

Abrams book is concerned with re-embodying nature, allowing its rich sensual dimensionality to impact us, move us, speak to and with us. Reading the book, I mourned the thinness of my own relationship to nature, but realised, at the same time that I do experience the resonance and richness of the living in my work as a biodynamic massage therapist and body psychotherapist. When we touch our clients (and also when not touching), there is actually available to us a vast amount of information perceived through all our senses. Abram's description of perceiving a raven strikes a chord: "My various senses, diverging as they do from a single, coherent body, coherently converge, as well in the perceived thing, just as the separate perspectives of my two eyes converge upon the raven and convene there into a single focus." [original italics] (p.62)

Abrams continues, and draws conclusions which brings into focus the core of our humanity: "My senses connect up with each other in the things I perceive, or rather each perceived thing gathers my senses together in a coherent way, and it is this that enables me to experience the thing itself as a center of forces, as another nexus of experience, as an Other." [my italics] (p.62) In other words, it enables us to experience, for example, persons as human, as having feelings, as "expressive subjects". (p.130) The opening of the senses, the connection through touch, which biodynamic massage invites, grounds and fosters compassion. Of course this is the ideal version - in reality there are multiple blocks and splits in client and therapist that limit this. But, my main point is, that the senses are crucial channels for relating, that allow us to know in a deep richly dimensional way, the other as a sentient - ie. conscious, aware, feeling - being.


The Senses Feed Our Process
In cognitive science there has been lots or research into how we process information, but there has been a striking lack of a model which could do justice to the obvious complexity of human beings. I find the metaphor of digestion a useful one for considering how we process information, and I'm currently engaged on further research into its various forms, such as assimilation, introjection etc. What I'm also interested in, and this is what I was putting forward rather clumsily in my talk at the AGM last year, is that the results of the processed information may show up in one of four ways. Basically I think awareness, or even a state which precedes actual awareness, of a dynamic in the client/in the relationship, manifests as either an image, a feeling, a thought (an idea/phrase), or an impulse. These are not separate phenomena - you can have all four at once, in which case there's a fairly strong integration of information. Or you may get something as faint as a snatch or a hint of something, say as a fleeting image, or a barely detectable impulse.

I want to emphasize the impulse here, not because its more significant than the other modes - feeling, image, idea - but because it is often neglected as a form of cognition. We know that thoughts, ideas, images are cognitive acts - some might dispute whether feelings are cognitive or not, but impulses are often considered to be outside of cognition, or as a result of lack of thinking. Yet, as massage therapists, more often than not we will select techniques, work in certain ways, go to certain parts of the body, touch with a particular pressure or quality, following an intuitive process. In this process conceptual and evaluative thinking may play an important role, but it is not necessarily at the forefront of our consciousness.


PART TWO

The Web of Life
I want to turn now to Fritjof Capra's book The Web of Life, which I found inspiring and quite relevant to biodynamic massage. I will pick up a few of its themes and try to illustrate some of the links I made while reading it. The Web of Life is both a history of the development of twentieth century science and a summary of the contemporary theory of the organisation of living systems. Some of you may be familiar with his earlier books - The Turning Point, The Tao of Physics. He's a physicist who first looked at physics in relation to spirituality and has written widely about the philosophical basis of science. This new book is a whole stage beyond those books - really another quantum leap forward. What he offers is a synthesis of recent scientific breakthroughs such as the theory of complexity, Gaia theory, chaos theory and other explanations of the properties of organisms, social systems and eco systems. These theories all center on the interrelationship and interdependence of all living things - "all things are connected", in the famous words of Chief Seattle.

It seems that science is catching up with some of the things we have always intuited and for me the experience of reading this book was confirming "Yes of course, it makes sense". Because for those of us who study and work with a bodymind process, its not news. Scientists, mathematicians and biologists are finding a way of formulating concepts to do with the process - the alivenesss, the complexity of - life itself.

Capra gives an extraordinary, illuminating and vivid history of science. He traces the root of self-organisation theory from the Gestalt psychology developed in Germany in the 1920s (a cognitive/perceptual school of psychology developing in parallel but not in dialogue with psychoanalysis). Gestalt psychology recognised the importance of the totality of a pattern, that we see things in integrated patterns. This is how we make sense of things, this is how information from the senses is processed. Gestalt psychologists demonstrated that problem solving in human being is not limited to trial and error, or conditioned responses but often involves higher level thinking that produces new vision, thoughts and solutions. (Concepts such as field theory, and the relativity and inidviduality of perception demonstrated in figure/ground were evolved at this time although it was not until the 1950's that Gestalt psychotherapy was developed in the US by Fritz Perls).

Skating down the decades of history, Capra then takes us to the 1940s and systems theory. Systems theory is basically recognising that the properties of parts can only be understood in the context of the whole. Of course this is obvious to us now but in terms of science this was a great breakthrough in understanding that everything is related and that you have to look at the context. Systemic thinking is the ability to shift back and forth between levels, and of course systemic thinking is what we are doing all the time as biodynamic massage therapists. For example, when you look at local changes in the client's tissue, you're seeing that piece of tissue but you are also aware of the context of the whole body, their tissue as a whole, the potential significance of this part of their body. You also consider it in relation to their whole history: what does it mean that they have distention pressure here, and now? What does it reveal about the client in relation to me? This is systemic thinking, its moving between levels, the physiological, the symbolic, the emotional, the energetic, and the different systems in the body as a whole. Systemic thinking has long been a fundamental skill of psychotherapies and holistic therapies.

I think one of the reasons that Gerda Boyesen was able to evolve such a sophisticated and broad ranging therapy had to do, amongst other things, with her continual curiosity, her flexibility, her capacity for to observe afresh, to switch between levels and to hypothesize across disciplines. In her papers you can hear the quality of her excitement as she notices a swollen membrane or a muscle twitching, or as she describes how she discovered peristalsis

Feedback
Moving on again to the 1960s, Capra takes us into the world of cybernetics which focused on patterns of communication, control and feedback in organisms and machines. Cybernetics is where the development of computers really began and, at this point in history, cognitive science was fond of comparing the brain to the computer, as if it were merely an information processing machine. Capra explains how that metaphor is completely insufficient, that though the brain is like a computer in some ways, there are very very important ways in which the brain is not like a computer. This is why people who have been working on artificial intelligence have not managed to get as far as they hoped. They can't get robots to think like people - they can get computers and robots to think in very sophisticated ways but computers lack what we call common sense, which is very context dependent, and its hard to program them for that!

The word cybernetics actually comes from the Greek word cyber which means to steer, so what feedback does, is it tell us which direction to steer in. It is a loop where information about what is being done comes back constantly to the source of the action (hence it is a loop). In a feedback loop you get information about what you are doing while you are doing it, and the importance of feedback is that helps self regulate the system. Its a natural corrective mechanism, whereby the organism learns about what its doing, and consequently adapts and develops and evolves. Self-regulation theory - a central premise of body psychotherapy - is a precursor to self organisation theory.

Now in terms of biodynamic massage I want to suggest that there are three particular ways in which we use feedback - firstly our being present with the client is a form of feedback. One of the comments often made by people who have had other forms of massage, like aromatherapy, is that there is a difference in the presence of a biodynamic massage therapist. The way that we are present in the room with the client is already on a very subtle level giving the client feedback about how they are. Just by our capacity to resonate, to tune in, we start to amplify the clients own internal signals. How we 'receive' the client creates an atmosphere for them to receive themselves. (This is actively supported by the boundaries of a therapeutic contract, such as a regular time and length of session in the same room, creating a particular kind of space. Your contract with the client and professionalism are also feedback to the client.) Biodynamic massage emphasises the importance of the emotional/ psychological feedback - the contact in the relationship - which can deepen self-awareness.
Then there is a second level on which we give feedback, which is to do with where we put our hands and how we move them on the client's body. This immediately gives them a whole load of information about where they are and what they feel. One way of describing bodywork and its effects is to relate it to the input of high quality information to the body about itself. By high quality, I mean, focussed, knowledgeable, attentive, with clear and flexible intention. It can enhance proprioception - the capacity of sensory receptors to detect the 'state', position, degree of tension etc in the muscle, connective tissue, tendons and joints. This is part of Deane Juhan's argument in Job's Body. He suggests that pleasurable positive information allows the body's natural intelligence to process what's going on more effectively, and to acquire a more enjoyable association with being embodied. In biodynamic terms, pleasure that the client can allow and accept strengthens the ego.

Holistic therapies generally rely on the feedback principle. Homeopathy is based on the idea of curing' like with like'. In Cranial osteopathy at its most basic the cranial therapist is just following what the body is already doing and slightly expanding it, amplifying it. In biodynamic massage there are a spectrum of ways of working, which offer fundamental and open-ended feedback. Our hands can reflect back to the client something about the tone, the texture, and the emotional qualities of the body. Peristalsis is a wonderful form of feedback for the therapist - it is so immediate and organic, and serves us as a kind of running commentary on the client's state as they experience themselves in relation to us. In addition, the therapist's attention to peristalsis subtley attunes the client to it as well. This feedback, influencing the therapist's response, fine-tunes the massage, and may then indirectly bring the client to a deeper awareness of their body processes.

Holding can be a straightforward form of feedback - you're here and these are my hands and I am with you. Its very simplicity may put the client in touch with a basic sense of safety, of slowing down. Or by contrast, it may bring up tremendous internal conflict and confusion, eg. I want you here but I don't trust you, it feels good but I'm frightened, etc. Then there are more obviously complex interventions, like deep draining where you are giving the body information about the type of the muscle at the same time as you are working to release it - its a way of putting people in touch with their holding patterns.

Somatic Metaphor as Feedback
The third way in which we can give feedback is through words, whether it be the questions we ask or the comments we make, as well as something we might call interpretation, like the somatic metaphors I talked about earlier. Even by asking the client "Are you comfortable?" " Do you feel warm enough?" you may be prompting the client to consciously gather information about themselves that they may not have taken into consideration. Highlighting the gaps in consciousness - like touching the parts of the body that are numb, or at least relatively lacking in sensory aliveness - can trigger significant re-organisation internally. Taking this further, recognising or even just exploring a potential somatic metaphor, is a high level piece of feedback. You give back a phrase about the body to the client that is relevant to their experience - you may have your hand on or over the organ, muscle, joint or area of connective tissue, at the time. You may pick up on their phrases, their descriptions of pain 'it feels heavy and stuck - this is unbearable - its like a knife' or whatever, their comments on what's happening in their lives -' I'm sick of it - he's a pain in the neck - I'm on my knees '- or use the phrases that jump into your mind 'she's slamming the brakes on - can't stomach it - deadening silence' etcIts a double feedback - connecting with them on the physical sensational level and on the emotional/verbal/thinking level. This is more of a psychotherapeutic use of massage - the feedback can have an edge to it, which can raise the charge and deepen a process.

Whereas in the first part of this article - How Many Senses Have We? - I focus on the therapist's sensory process, here the emphasis is on facilitating the cohering of sense perceptions in the client. Biodynamic massage can be used to support the client in experiencing greater differentiation and detail in their self awareness. The biodynamic principles are those of allowing, trusting, providing space and time for the individual to digest (themselves). Such biodynamic interventions as leaving a little time at the end with the client resting on their side support the development in the client of an embodied sense of self.


Let me give an example of feedback on more than one level. I have a Jewish client, whose family fled Europe during the Holocaust; she lost not only relatives but a whole community. Her struggle on a deep level is with issues of loss, abandonment, displacement and dispossession. It occurred to me to focus on her bones because bones are connected to the root chakra; to the deepest tribal level of connection - of longing for and belonging, being part of the structure. When I asked her the question "Do you have any sense of your bones?", she found it hard to relate to my question. She has a medical training but the sense of having bones was unfamiliar. I worked with lifting, and periost, and as I put my hands on her bones, I said quite matter of factly "this is your scapula", "this is your sacrum" etc. She knew the anatomy of it, but what was new was just recognising the experience of bone. After the first time we did that she told me the next week that she went home and slept all that night, and all the following day. She got up in the evening for an hour and went straight back to bed. She was not ill, just "bone tired". She had been put in touch with her bones and having not been 'in' her bones for most of her life.

Work in Process
I am aware that the threads of this article have not quite been pulled together, rather like the talk I gave. I'm coming across fascinating material from other sources so frequently at the moment and the process of trying to integrate with my own experience as a biodynamic massage therapist and body psychotherapist is very compelling and open - ended.

The other part of this talk 'Hamlet and the Somatic Metaphor' is on Somatic Metaphor .

Email Roz at thinkbody@lineone.net

Return to Home Page