Thinking Through the Body

See below course decription for lecture on the Autonomic Nervous System given for Confer, 26th March 2001
Exploring the Mind in the Body -

A Seminar Series on "The New Anatomy" at the Chiron Centre for Body Psychotherapy, 26 Eaton Rise, Ealing, W5 2ER

We are living in exciting times. Radical breakthroughs in grasping the complex physiological basis of mind are emerging. For this seminar, I have brought together insights from body psychotherapy, psychoanalysis, holistic theories and recent neuroscientific research. We will explore both 'hard' facts and 'soft' processes to deepen our understanding of the body. Each evening will focus on a different aspect of the body through experiential exercises, theoretical input and discussion generated by the different perspectives of the participants.

This course will be run in Spring/Sunner 2002 over 8 Friday evenings.

Semnar 1. Development 8th February 2002, 7-10 pm

Neuroscience, psychoanalysis and body psychotherapy theory all agree that patterns laid down in utero and in infancy and in childhood carry on into adulthood in the form of persoanality and its embodiment in physiological structure. This seminar provides an overview and introduction to the major themes of the course.

Seminar 2 Bones 1st March 2002 7-10pm

The skeleton is our framework . It mediates our relationship to gravity, a constant force affecting our lives. It effects and is a reflection of our capacity to co-ordinate, balance and articulate in spatial, perceptual and conceptual fields. It contributes to the organisation of our thinking.

Seminar 3. Muscle 12 April 7-10 pm

Muscle enables us to act and react, to reveal or inhibit. Muscle is the convergence zone for habits, skills, and emotional learning, in other words, conscious and unconscious intention. Patterns and textures in muscle tone embody internal conflicts and resources which tell the unique story of an individual. (see below my article "The Motoric (muscular) ego: What we can learn from the Parallel and Paradoxical Functions of both Muscle and Ego")

Semnar 4. Fluids, 10 May 2002

The quality and intensity of our feelings is manifest in the changing states of the fluids (blood, lymph, and cellular) and their biochemical content s (hormones, peptides, antibodies). How we manage feelings is reflected in the way connective tissue encysts, contains or disperses the fluids.

Seminar 5. The Senses, and the Skin 14 June 2002

Via the senses and the skin we have contact with the world around us. How we transform, are nourished by, block or distort the world is intimately related to how we use our senses and our skin. The senses are dynamic and the interplay between them can create or reduce our sense of 'depth of field' in life.(A talk given to Biodynamic Massage Therapists 'How Many Senses Have We?' opens up the theme, although the scope of this seminar will include a look at the concept of the 'skin ego' (Anzieu), and at autism)

Seminar 6. The Nervous System 12 July 7-10 pm

The autonomic nervous system, a key link between the internal organs and the brain, determines changes in arousal/relaxation, and where energy is directed in the body. It articulates patterns relating to survival in both the short-term (flight, denial, aggression etc) and the long-term (processing, absorption, releasing).

Time: 7 &endash; 10 pm at the Chiron Centre, London W5.

The Autonomic Nervous System: Barometer of Emotional Intensity and Internal Conflict

A lecture given for Confer, 27th March, 2001

As a body psychotherapist, I come from a therapeutic tradition, whose basic premise is that bodily processes are intrinsically involved in psychological processes, and vice versa. In this field the autonomic nervous system has long been recognised as a barometer of emotional intensity and internal conflict. Body psychotherapy developed out of the work of Wilhelm Reich, who was a student of Freud's. Its basic premise is that the mind and the body cannot be understood as separate phenomena, and therefore need to be addressed together in psychotherapy.

In body psychotherapy, the Autonomic Nervous System has been known by the more archaic term, the Vegetative Nervous System. Vegetative is derived from the Latin vegetare which means to quicken, animate or bring life; the autonomic nervous system governs the 'involuntary' visceral processes. I am going to be talking this a lot this evening about variations in autonomic function, and its role as a homeostatic regulator of emotional intensity. But its important to make the point that the ANS function of maintaining parameters is essential to life - a complete breakdown in functioning leads to death. Between initial perturbance and imbalances, which go back to infancy, and death there is usually a long intervening process of attempts to re-organise and rebalance the psychophysiological system.

My proposal this evening is that object relations are internalised in the body at every level of function and structure, including as modifications to the autonomic nervous system. I will be unpacking Reich's formulation that: the development of character is a progressive unfolding, splitting and antithesis of vegetative (i.e., autonomic functions). Although I'll be drawing on some very recent neuroscientific and metapsychological thinking, I want to give credit to Reich's insights which were so ahead of his time. (see end for discussion of Reich in relation to Schore]

I am going to take you from a basic picture of the functioning of the autonomic nervous system, as you would find it outlined in any physiology textbook, through a more developed holistic conception of it, to a model which situates it directly within conscious and unconscious communications/exchanges of object relations. As well as drawing on information from different disciplines, we will be moving from a simple cause and effect model of the nervous system to the more recent scientific perspective of dynamic complexity. If we are to progress in our understanding of the capacity of body and mind to function both as a unity and as a split object/subject, we have to firmly put behind us a search for 'cause', and even an explanation in terms of symbolic language, and look instead at emergent properties of complex interactions between systems (bodily, social, etc)

The Basic Physiology

The nervous system as a whole includes the Central Nervous System, consisting of brain and spinal cord, and the Peripheral Nervous System, whose nerve fibres connect all parts of the body with the central nervous system. The Peripheral Nervous System is further subdivided into two branches, the Somatic Nervous system and the Autonomic Nervous System. All these nerves are outside the Central Nervous System. The Somatic Nervous System controls musculoskeletal movement, and conducts sensory messages from the body to the CNS. (model is increasing decentralisation)

The Autonomic Nervous System has two branches, the Sympathetic and the Parasympathetic, which regulate the involuntary processes of the body, the viscera, and sense organs, glands and blood vessels. In evolutionary terms it is older than the CNS and its anatomical circuitry is broadly dispersed, creating a general response, quite unlike the highly specific pathways and response of the CNS. This generalised, widely distributed structure enables it to mediate overall changes in state; it is part of the limbic system which has also been known as the mammalian or emotional brain.

It was called autonomic because it was believed to function autonomously &endash; we now know that it is dynamically related to many other parts of the brain especially the orbitofrontal cortex. Autonomic also means self-regulating and this is a key principle of all body systems, which depend of constant feedback in order to maintain homeostasis. There are multiple feedback loops in the body which continually send and receive information about what's going on and the ANS is part of this wider complex.

In standard physiology the two parts of the ANS have been perceived as functioning reciprocally: the sympathetic governing arousal, the fight or flight reaction and the parasympathetic involving relaxation, recuperation and digestion. The sympathetic nervous system is activated by any stimulus over an individual's threshold (and the threshold can vary enormously), including feelings, and by noise, light, drugs and chemicals (e.g. caffeine).In response to the stimulus an immediate anticipatory state is generated by the release of adrenaline. This causes the heart to beat more quickly and strongly, increases blood supply to the muscles, raises blood pressure, dilates the bronchii and increases the breathing rate, raises the blood sugar level for increased energy, speeds up mental activity, increases tension in the muscles, dilates pupils and increases sweating. Non-emergency functions, such as digestion are lessened or suspended. (priming phase &endash; short-term) Walter Cannon coined the phrase 'fight or flight' to describe the function of the rapid mobilisation of resources.

The parasympathetic nervous system comes into operation after the stimulus has been responded to and action taken. It has the opposite effect to sympathetic activity, allowing the body to wind down and re-balance. The activation of the parasympathetic nervous system encourages relaxation of muscles, slowing the heart rate and lowering the blood pressure. It assists the breathing to return to its normal rate, digestive juices flow, bladder and bowels are ready to function, the pupils constrict and immune functions, such as the production of white blood cells are re-commenced. The parasympathetic mode supports rest and sleep. (the investment phase - long term). The standard physiological model of the ANS is of reciprocal tension - with the two parts keeping each mode in check &endash; When the sympathetic goes up, the parasympathetic goes down. A good example of optimal autonomic balance can be seen in cats who respond alertly to certain sounds or movements, but, as soon as the situation is assessed as safe, return immediately to a relaxed state.

Lets just stop a minute to become aware of our own autonomic state: tongue, heart rate, peristalsis, skin &endash; temp and moisture &endash; warm & dry; cold&wet; relaxation/tension. Attentiveness &endash; alert to broad awareness..

An understanding of the autonomic nervous system in terms of 'stress' was popularised in the 1950's in the work of Hans Seyle. This marked the beginning of the extensive concern with stress in psychological and medical thinking that is still around today. Seyle identified the physiological responses to environmental, lifestyle and personal change. He described a General Adaptation Syndrome which consisted of 3 stages: first, the emergency or alarm reaction which prepares the organism for immediate fight or flight; then there is the resistance stage in which many of the physiological changes associated with the alarm reaction are reversed, and the organism has increased resistance to the stressor. The final stage, exhaustion occurs when the body's ability to deal with stress runs out. It's a concept that is still useful and widely accepted. We notice that people can fight off illness when there are demands that need to be met, such as work, but that when they stop for a holiday, they succumb to illness.

The problem with the ubiquitous use of the word stress, as Rollo May pointed out in the revised edition of his classic work The Meaning of Anxiety, is that it is used as a synonym for anxiety and they are not the same thing. Anxiety is an intrapsychic phenomenon, which originates in a repressed internal conflict, often a repression of instinctual impulses that are actually bound up with survival. Stress, on the other hand, is typically attributed to externals &endash; stressful working and living conditions. It puts the emphasis on what happens to the person. It has an objective but not genuinely subjective reference.

The emphasis on the perception of danger in the name 'fight or flight', which embeds its meaning in more primitive roots, is both a liberating and limiting concept. Where it is useful is in helping us understand that any situation that is subjectively perceived as a threat to one's integrity - from an insult, to threatened loss of work &endash; can trigger a fight/flight response. But it has also detracted from an understanding that much subtler feelings , combinations of feelings, and conflicting feelings correlate with autonomic activity.

Emotional-Physiological Cycles

In body psychotherapy, and more recently in neuroscience, sympathetic activity, has been seen more broadly as an indicator of an impulse or a feeling being stirred. The word sympathetic &endash;sym pathos means with feeling. It is most easily understood as an upsurge &endash; those feelings which are experienced as coming UP &endash; anger, fear, excitement, desire, hatred &endash; and which if expressed involve movement out, or towards, or in the case of fear, away from, an object. Sympathetic physiology increases energy and readies the body for action &endash; so it is also about the need to do, express, act.

Conversely the parasympathetic action is a concomitant of coming DOWN &endash; disappointment, grief, shame, guilt, despair; and contentment, peacefulness, satisfaction - feelings which involve a decrease in tension, withdrawal of energy inward and tend more towards introspection. Laughter and tears are both usually a sign of parasympathetic activity.

Reich pointed out that pulsation, the movement of energy in and out &endash; is a fundamental quality of living organisms. It's evident in our breathing, heartbeat, and our need to take in and expel food. The autonomic nervous system which governs these activities is a manager of metabolic energy &endash; increasing it when necessary, conserving it the rest of the time. Sympathetic activity is catabolic &endash; it breaks down substances in the body to produce energy for activity. Parasympathetic activity is anabolic &endash; it builds up and restores. The parasympathetic phase is vital to the maintenance of long-term health. In optimal psychological and environmental conditions the body swings into parasympathetic mode to repair and maintain health.

It is well understood and documented now that chronic sympathetic activation, which can have many causes, undermines good health. A combination of factors means that the predominance of the sympathetic mode is the norm. Stimuli over a certain threshold of loudness, brightness, speed affect the nervous system, as do stimulants in food, drink and drugs. Culturally we're into over rather than under-stimulation. Further, an increase in acidity at cellular level predisposes the body to sympathetic activity (and correspondingly alkalinity links with the parasympathetic). And so, of course, vice versa: if the body is in a constant state of sympathetic activation, there is an over-acidity in the tissue, which has an effect on health.

One way in which the body protects itself from emotional intensity is the development of chronic muscular tension, which dampens down both external and internal stimuli. Reich called this character armour because it establishes ongoing defences against internal conflict &endash; the location of the armour relates to specific developmental conflicts around bonding, nurture, self-control, sexuality etc. Although sympathetic activity increases muscular tension, individuals with sustained high tension tend to have lower autonomic arousal than those with less muscle tension. Muscle tension creates a buffer, which reduces anxiety but at a cost &endash; a loss of contact with oneself and others. It can be a negative loop that leads to loss of self-regulation.

Too much muscular tension impairs health because it constricts and inhibits spontaneous processes in general (i.e. including feelings and thoughts), such as breathing, and the venous and lymphatic circulation, which are responsible for clearing the body of toxins. (Interestingly the word stress from the Latin stringere (to draw tight) is similar in meaning to the Latin word angere (to press tightly) which is at the root of our words anger, anguish and anxiety. This repressed inner turmoil translates in the body as tension at every level (visceral/muscular/autonomic etc), including hardening and narrowing the arteries, as in angina, a medical condition which can precede heart attack.)

On the other hand, chronic parasympathetic activation, which correlates more with psychological collapse and depression, is not healthy either. Its characteristics are low blood pressure, sluggishness. The organs and muscles lack tone &endash; in other words there is not sufficient tension.

Now I want to look at the correlative psychological modes of the sympathetic and parasympathetic activity. These are general qualities rather than fixed attributes.

Sympathetic Parasympathetic

Activity Receptivity

Speed Slowness

Tension Relaxation

Focus Scope

Convergent thinking Divergent thinking

Extraversion Introversion

Goal-oriented Process-oriented

Agency Presence

Direction Elaboration

So these are all resources, complementary modes, exquisitely differentiated states. Optimally and in health these modes support each other, interact, balance and modify the use of energy. Like a happy couple, they dance together, supporting creativity, flexibility and well-being.

Reich perceived the reciprocal action of sympathetic and parasympathetic as part of a four-beat cycle: tension-charge-discharge -relaxation. This is known as the vasomotoric (vaso &endash; blood; motoric &endash; mvement) cycle, and is a holistic model embracing both psychological and physiological function. One image I have of the sympathetic is the coiling of a spring; the parasympathetic is the rebound back to a resting state. The part in between &endash; the spring springing &endash; is a crucial transition. In the coiled wire this action is governed by physical laws &endash; the extent of its spring depends on fixed physical parameters. But in a human process its much more complicated. Suppose the client has an impulse to say something in a public setting which has a bit of charge &endash; they gather up the energy. They say it, the effects of saying it sink in. That's a cycle. Now suppose something interrupts this &endash; they dismiss the impulse almost as soon as they've had it, or they allow the excitement and anxiety to build, but then they bail out at the last minute, or they say it and are so overwhelmed with having said it that they can't follow through or take in the response. Or, they say it, start integrating, unwinding, but then are left with a remnant of anxiety so they can't completely let it go.

I'm sure all these patterns will be familiar &endash; the point I'm making is that they have direct autonomic correlatives. In standard physiology the autonomic nervous system is a closed system, where homeostatic balance is maintained by innate self-regulation. The parasympathetic will inhibit the sympathetic when it has reached a certain point, and vice versa. Its what keeps us alive. But you will understand that with emotional process it can get a lot more complex, and small variations in function have a significant initially subtle effect. This is because the body is also a relational body which makes it an open system, subject to modification by the impact of events and processes and the external environment.

Autonomic Splitting

In the example I've given, the inhibition at any point in the cycle means that something is not integrated &endash; its split off. If the words are not said, the person will inevitably start to wind down sooner or later &endash; just because of the in-built homeostatic regulation. The energy aimed for the speaking might be turned into a self-attack, or maybe the person will think it over and be a bit resigned. In this case the transition to the parasympathetic may overlay ongoing sympathetic activity. And this is a key thing to grasp. The internal psychological conflict operates as an autonomic split. The parasympathetic can mask the sympathetic, or the other way round. The two systems can be in active conflict, or lacking reciprocal tension and therefore chaotic.

With the parasympathetic masking the sympathetic, the person might leave the room and cry hot angry tears and feel collapsed but be unable to receive support because they are still angry. The inhibited anger/aggression isn't quite assimilated so that the parasympathetic mode of release through tears and a more vulnerable state can only be partially activated. Or the other way round, (sympathetic masking parasympathetic) they might feel deflated inside, but rally themselves to get on with it, thereby using a sympathetic mode to force the start of a new cycle. Here the sympathetic might manifest as a slightly compulsive quality of talking and acting &endash; a bit speeded up, overriding a deeper perceptible 'flatness'.

Obviously it is quite impossible for all impulses to be satisfied - the nature of life essentially means that there is a huge over-presence of all thoughts and impulses. And the way we deal with this is both positive and constructive (acts of creativity), and negative and destructive. Human beings have quite extraordinary and ingenious strategies of transforming the abundance of life stimuli. That said I'm going to focus this evening on how in particular the inhibition of strong emotions has an effect on health.

The autonomic split resulting from incomplete cycles may be a temporary compromise, but often it's a more fundamental physiological pattern (I'm going to talk about its developmental origins in a few minutes). The split off remnants remain in the body as generalised or localised areas of muscular tension, pain, flaccidity or numbness. They linger as particular controlled or constricted breathing patterns; for example an in-breath stimulates the sympathetic. It's a spontaneous thing to do as we initiate, but if we fear passivity we might force the in breath. The parasympathetic is activated by an out-breath &endash; again a natural way to end, or a defensive way of trying to get rid of stimulus (for example, the heavy sighs of someone who is repressing anger). Autonomic splits can lead to hormonal or immunological imbalances (the hypothalamus, which mediates autonomic action also effect the endocrine and immune systems).

What I'm saying is, an aspect of physiological functioning may become &endash; in Reich's word - sequestrated. Sequestrated means to seclude, set aside, to remove, render ineffective. Reich's word emphasises something temporary, lawful, purposeful. The splitting off &endash; paradoxically - maintains some kind of integrity. A part of the body holds on to its original impulse. This brings me to another way of translating autonomic - my favourite - from the Greek auto - noumous : 'the law of the self'. I believe that the functioning &endash; including the splitting - of the autonomic nervous system is fundamentally bound up with preserving the dynamic integrity of the self.

In health, physiological and psychological are relatively synchronous. There is a congruence between the feeling psychologically perceived and the feeling that is being embodied. Illness is always initially an attempt by the organism to re-stabilise after some impingement. It begins as a spontaneous response to a situation &endash; maybe a single event or a complex circumstance, with perhaps both external/internal factors. (I include in this both something actual, like a virus, and something subjective, like an unconscious fantasy)

Now before going further with this more complex model of autonomic fragmentation, I want to briefly go back to the characteristic defences and ego capacities which correlate with these two modes. I want to emphasise that these links I am making between autonomic states and defences are not fixed, and cannot be diagnostically isolated but perceived as part of an energetic pattern. They represent tendencies; autonomic states, as I have suggested, can overlay each other and fluctuate in ways that defy simplistic categorisation.

Sympathetic Parasympathetic

Flight Collapse

Aggression Passivity

Opposition/reaction formation Collusion/retroflection

Blame others Blame self

Hyperactivity Hyperreflective

(productivity without creativity) (creativity withoutproductivity)

Projection Introjection

Omnipotence Omniscience

Mania Depression

These defences arise from the foreclosure of an emotional-physiological cycle. We understand from Klein that these defences originate in the infant's vulnerability to and dependence on the environment. In adults the same physiological patterns and defences may be employed as habitual modes or under challenging circumstances, when the individual's capacity to act (sympathetic) or to digest feelings (parasympathetic) is inhibited for any reason. We could say that these defensive modes are signs of the organism moving into the margins of stress. I want to make the point that while that these defences are still healthy and functional while they are context appropriate. It is only when the splits become chronically embedded in alterations of the structure-function of the ANS that they are pathological.

I can think of a client who, because of a complication in labour, had to go into hospital although she had wanted to give birth at home. She had to deal with her dependency on the medical staff and her hatred of what they represented for her - a controlling, cold, mechanical mother. Everyone in the hospital became seen as either good or bad &endash; she was able to trust absolutely in a few key figures and managed to get rid of those she didn't like, either by ignoring them or by being overtly hostile. As soon as she had actually given birth, this dramatic splitting subsided, because it had fulfilled its temporary function &endash; to postpone one emotional cycle while a more urgent cycle was in progress. An important part of her resolution of her experience in hospital was talking, reflecting and writing about it. She called her birth story 'Chiaroscuro', from the Italian for light/dark &endash; ie. the good and the bad.

Self-Regulation: A Developmental Perspective

In a fascinating and detailed study of the relationship between attachment and neurological development, Allan Schore has helped illuminate just how individual nuances in autonomic activity are influenced by the infant's ongoing relationship with the mother. A baby's capacity to act is incredibly limited by its physiological and psychological immaturity &endash; a baby cannot, obviously, fight or flee something overwhelming. And the something overwhelming might simply be its own need of food or contact (Winnicott's 'clap of thunder' captures the experiential impact). It is dependent on mother or another caregiver for emotional and environmental regulation. If the parent can soothe and stimulate appropriately, these functions are internalised as capacities in the nervous system.

In a newborn baby, it is now suggested, the reciprocal tension of sympathetic and parasympathetic are not well-developed. A good example of this is colic which I did some research on a few years ago . Colic is a very common but quite distressing phenomena where the baby will have difficulty feeding and can cry every day for hours. The digestion (parasympathetic) is disrupted because the baby is over-stimulated (sympathetic). This over-stimulation may be a result of many things &endash; compression of the vagal nerve &endash; a crucial mediator of the parasympathetic nervous system -during birth; an environment or life-style that is unsettling; internal conflict in the mother etc (or of a combination of these). One of the best ways of reducing colic is for the mother to keep the baby in close physical contact &endash; such as in a sling &endash; for long periods. Her body and her more mature nervous system can help regulate the baby's arousal.

As the baby develops, the parasympathetic mode ( the soothing function) becomes more an established and is more able to inhibit the sympathetic, in other words to modify stimulation. The parasympathetic mode has a role in impulse control. However it can be over-dominant. If the parent greets a toddler's excitement with harsh disapproval, the toddler may respond to this withdrawal of contact with parasympathetic over-activation &endash; i.e. a collapse. The parent's rejection is experienced as a real down fall, a drop into shame, despondency etc. Another toddler might respond by further demands or mischief, which might successfully draw the parent back into relation, or it might be met with a slap. From these two examples I hope it becomes possible to imagine just how the interplay of the two modes can reflect a containing parent, or in a more conflicted or chaotic environment, the opposite. Constant opposition between parent and child may become internalised as an antagonistic relationship between the sympathetic and parasympathetic.

Deficits and failures in the primary relationships are laid down as autonomic patterns, which reflect the infant or child's default style of coping with its feelings. Styles of managing feelings are modelled explicitly or implicitly in the way parents respond or react to events. Autonomic identifications and polarisations become built in &endash; for example, a child may react like the over-excited mother (sympathetic); or they may become the complementary object and be mother's 'rock' steady, dependable, imperturbable (parasympathetic). Of course, as with all object relations, the child will internalise both, and what is lived out in their typical mode of being may give way under stress to its opposite. (The terms 'autonomic identification and polarisations' are mine; the examples are my phenomenological extrapolations from Schore &endash; his own descriptions are purely technical.)

Repeated patterns of interaction between parent and child have long term effects via the ANS. The ANS manages quantity and distribution of energy in the relationship between the organism and the environment. When the response called up in the organism is overwhelming, the overload can be managed in a variety of ways, intensification of autonomic reaction, localisation of a charge within an organ or a muscle group; usually all these means will be deployed to some degree, with the correlative psychological defences. What happens next is somehow more significant: the organism struggles to find equilibrium, to assimilate, elaborate or bind the energy/feelings in the longer-term. The psychologically and physically robust individual has the most options for tolerating, adjusting to or acting upon the environment. The more limited an individual's options, the more likelihood of chronic psycho-physiological compromise in the direction of illness (visceral, tissue, muscle and skin armour limit the health-maintaining functions of the organism); and behaviour including self-management strategies like addictions.

I want to move on to say something about trauma, which can be viewed specifically as a breakdown in autonomic functioning. So far I have talked of reciprocal function of parasympathetic and sympathetic, and of splitting or antagonism between the two systems. In trauma, we see another phenomenon. Instead of mutual inhibition, both sympathetic and parasympathetic become more and more strongly activated. In the face of a strong stimulus and a perception of no way out terror is aroused and can end in paralysis, freezing, black out etc If the danger cannot be met by fighting or running, or by expressing vulnerability, co-operativeness or whatever (I'm thinking of traumas as varied as rape, train crashes, fires, abduction etc), the body, like the mouse caught by a cat, may involuntarily play dead.

One of the defining characteristics of post-traumatic stress is a chronic disorder of the autonomic nervous system, manifest as a strong tendency to startle, blackout, hyper-irritability, disrupted sleep etc. A small but significant stimulus can trigger a panic attack. Where the trauma goes back to infancy and is an intrinsic part of the relationship with the caregiver, there is more likely to be severe personality disorder.

Four types of Autonomic Dysfunction

Characterologically and culturally, individuals will have predispositions towards the sympathetic or the parasympathetic. For example, racial groups originating near the tropics, needed to be more sympathetic dominant, to respond to the challenges of that environment, in which the capacity for flight was necessary. Further north, where people migrated to settle and farm, a more parasympathetic dominant tendency became embodied. Even farther north, where endurance was the main survival quality there was an even stronger tendency to parasympathetic predominance. Nowadays, with so much global movement and multi-racial interweaving, such simple metabolic biases no longer hold true. This reminds us of another way in which we need to take on board complexity in the organism-environment. (These patterns are recognised in Ayurvedic medicine, and have been more recently popularised in the blood type diet)

By autonomic dysfunction I really mean a chronic pattern of coping via psychological/physiological defences. Essentially I am proposing four types of autonomic dysfunction, which are reflected in all aspects of a person &endash; from subtle psychological and physiological processes to more extreme illnesses and disorders. In doing so I'm aware of collapsing normal distinctions between categories. This model is very speculative but it does draw on a variety of sources, including the major psychoanalytic theories of illness, recent neuroscience, holistic therapies and body psychotherapy.

These autonomic splits can exist in various combinations at various times and be more or less creatively handled. In chronic and serious illness, an equilibrium is established via some kind of compromise of an internal conflict. Depending on the nature of the condition, the symptoms may represent an appropriate adjustment, or a sustained defence against the intensity of one or many feelings.

I want to make the point that as well as being influenced by emotional factors, there are of course genetic weaknesses and the impact of specific factors in the physical environment which play a part. In fact what I am proposing is an environmental-organismic model, rather than an a purely psychological model. (see below for discussion of terms organismic-environmental)

The first kind I'm calling sequestration, using Reich's term. This is where a more or less isolated organ, muscle group or physiological function becomes symptomatic. It's a kind of damage limitation, and its isolation in the body is also a form of representation. And so a symptom emerges &endash; a frozen shoulder, an ovarian cyst, and a sore throat. In psychoanalytic literature this may be perceived as a break down in symbolic thinking &endash; the body becomes the metaphor. Such a view is also well popularised in various humanistic and New Age therapies where there is an emphasis on discovering the message that the symptom is carrying. There are many spectacular examples of symptoms clearing up when the message has been received and understood. (see below in 'Ways of Working' for further discussion of symbolisation).

A simple example of symbolisation is the woman with a severe facial rash, who, it eventually turns out, has been desperately putting a 'brave face' on deep distress and anxiety. In a more complex introject, I had a client with a frozen shoulder. There were obvious conflicts around shouldering responsibility and feeling burdened which we explored. Over a three month period I worked with increasing body awareness, exploring the mobility of the shoulder, releasing the tension in the neck through holding the head. But what became increasingly evident to me was that the client was struggling to avoid very painful feelings of exclusion and rejection. The frozen shoulder was an introject of the 'cold shoulder' she felt she has been given in a current life situation, in her early relationship with her mother, and in the transference with me.

The second kind I'm calling antagonism. Here there may be a war of attrition or a full scale battle between the sympathetic and parasympathetic, which correlates with a battle around drive and self-control. Heart attacks may fit more into this pattern &endash; the individual pushes themselves to achieve, maintaining overdrive, controlling anger, disappointment, frustration &endash; pushing on, on, on till the heart cannot cope. Heart attacks happen more often on a Monday and cluster around 9am &endash; the day and time when most people go back to work after the weekend.

This antagonistic pattern can also fuel addictions &endash; most addictive substances either stimulate, and wake you up, or they take you down and mellow you out. We can start to use drugs of all kinds, including caffeine, nicotine, alcohol, tranquillisers &endash; to get ourselves into the preferred autonomic state &endash; it's a sort of self-medication.

The third kind I'm calling instability. Here the two parts of the autonomic nervous system are failing to regulate each other, producing wild fluctuations in mood and body symptoms. This client presents as hysterical or hyperchondriac &endash; symptoms move around, change, get very intense but suddenly disappear. The key characteristic is instability. Doctors may investigate and find nothing wrong, but the client is tormented, and frightened of the body. I had a client with a history of chronic abandonment. In our work together, I would often sense that she had lost all connection with her legs. It became clear that this was associated with abandonments of any kind, where it seemed that 'the carpet was pulled out from under her feet'. She didn't lose the capacity to walk (a more extreme hysterical conversion), but to connect energetically with her legs and the ground (i.e.. a matter of fact here and now reality). Triggered by fear of abandonment, she was in some respects 'gone'. With my drawing attention to her legs, and putting my hands on her feet, she was able to re-own her legs (see below for discussion of motor-sensory integration.)

The fourth kind I'm calling trauma. The two parts of the autonomic nervous system escalate their functions. Here the symptoms are characteristic of high stress &endash; panic attacks, cold sweats, palpitations, nightmares, outbreaks of violence, inability to cope, rapid changes from hot to cold and back. Trauma, which makes the autonomic nervous system highly unstable, can contribute to any of the above patterns. In many cases, the traumatised client is more contained by illness than not &endash; hence the stubbornness of certain illnesses (i.e. resistant to interpretation) which are apparently 'psychosomatic'. Illness can be a sign of health &endash; the body is being allowed to elaborate its terror, rather than held in a state of permanent defence against spontaneous processes.

These splits could be seen as a progression of disturbance &endash; the ego is relatively rigid in the first two examples, and more fragile in the second two. In a very general way, we could say that in sequestration and antagonism the individual makes use of their body; what is feared is 'excess' i.e.. strong unmanageable feelings. In instability and trauma the body is experienced as radically unsafe; it is feared but not used. In the first two patterns, the body is a controlling container; in the second the body becomes the anti-container. These patterns repeat and embody object-relational experience, as well as racial/gender/social patterns, possibly encoded at a genetic level.

Sensory Motor Functions and Splitting

Having outlined the link between autonomic and emotional development as a relationship function, I want to go back briefly to physiology to look in more detail at how these patterns become embedded. There are multiple motor sensory loops in the body which send and receive information. They influence all body functions &endash; for example, the immune system responds to changes in the body, with appropriate immune reaction, such as the production of antibodies. And this loop stimulates concurrent signals that influence the individual's behaviour &endash; such as sending stimuli to drink or rest. Contributory factors to many chronic illnesses include the prolonged overriding of messages from the body to stop and rest; and chronic dehydration because most people have simply lost a healthy thirst reflex. In other words, there is a split between spontaneous (instinctual) survival impulses on the level of sleeping and drinking, and other influences (pressures of modern life) which reinforce a dissociation from body signals.

To understand why this happens we need to recognise that self-regulation in the widest sense (including its autonomic/emotional aspects) is intrinsically bound up with complex neural and chemical motor-sensory feedforward and feedback loops. When we use our muscles, for example, there's not just an instruction from the brain, but feedback from proprioceptors in the muscles and joints which monitor changes in tension, the speed of change, changes of pressure in the tissue, the position of joints in relation to each other etc. Although largely outside awareness the proprioceptors provide a dense, dynamic 3-d map of the body in space and in action. (See my article on the Motoric Ego, also on this site) Similarly there are interoceptors in the organs, complex chemical connections between all parts of the body which relay a constantly updated picture of what's happening in the body.

The Autonomic Nervous System and the Somatic Nervous System &endash; the muscular system &endash; are regulated by sensory-motor loops. The sensory input to the ANS concerns the exact nature of visceral activity, blood composition etc; the motor output actively modifies the organs, muscles, blood vessels etc. The pioneering neurologist Antonio Damasio has emphasised that the brain is dependent on the body for self-knowledge. Rather than language being the necessary feature of self-knowledge, it is the critical multiple feedback loops which inform the brain about activity in the body, which constitutes the basis of all self-knowledge. He argues that the emergent properties of complex activity in the body are emotional states. Feeling feelings allows us to make sense of our environment and act appropriately. (Note: self-knowledge is distinct from self-consciousness [the capacity to reflect on oneself]. Self-knowledge supports appropriate actions in a survival context, and provides the basis for more sophisticated reflective activity. )

Putting together some of the implications from Schore's and Damasio's work, I would say that when the containing function of relationship fails, there is a correlative breakdown of the sensory-motor loop. The sensory component (including sensation and feeling) is split from the motor function which is necessary for acting. Both feeling and doing are life-saving functions &endash; working together they constitute experience.

Interestingly, Bion defines 'thinking' in terms of the capacity to experience, to make links, and he attributes this to being able to integrate and assimilate sensory images (the alpha function). Intense feelings always have a correlative motor &endash;i.e. muscular &endash; impulse which includes all the primitive urges &endash; to suck, to hit, to reach, to cry, to tear, to cling. Bion argues that restraint upon motor discharge is provided by means of the process of thinking. I would qualify this by saying that motor restraint needs to be accompanied by the sensory information of the act of restraint in conjuction with the image of what is being desired. The linking of the two constitutes thinking. By contrast, splitting the motor and sensory function reduces the intensity and dilutes the conflict to make the self in relation to object less overwhelming, less threatening. The splitting may subsequently be followed by more integrative reflective activity, or not, depending on the autonomic capacity to contain the charge.

The motor-sensory split will also be reflected in a sensory dysfunction &endash; often marked by numbness or pain; and motor dysfunction &endash; typically manifesting in rigidity/flaccidity of the muscle, or a compulsive motor discharge (hyperactivity). An individual's body will be characterised by its own particular variations in muscle tone, body awareness, differentiation of muscle groups, tissue textures etc. The more 'split' the mental functioning, the more splits are observable to the trained body psychotherapist. The bringing together of sensory awareness and motility can increase healthy integration and differentiation of functions,

The word proprioception means 'to receive oneself', literally 'to be in touch with oneself'&endash; it is the basis of physical and emotional health. It is a condition of healthy embodiment ( by embodiment I mean congruence of physiological and psychological). Alexithymia, the condition of being unaware of one's feelings, and therefore unable to articulate them or think about them, must reflect an impairment of the integration of sensory information, and has an established connection with psychosomatic illness. A more extreme version of this, anosognosia (from the Greek nosos, disease; and gnosis, knowledge) is clearly determined by damage to specific parts of the brain. On the basis of his study of anosognosics, Damasio has clearly linked the failure of areas of the brain to integrate information from the body with the inability to feel and to reason, despite no damage to the language centres of the brain.

The contrary state to fully functional proprioception&endash; and the basis of ill-health, I want to suggest - is omnipotence. By definition omnipotence implies a dissociation from bodily functions &endash; because bodily capacities determine precisely the limits of what we can or can't do. The practicing phase is when the toddler has to repeatedly discover the physical and emotional limits of his/her capacity. The tears and tantrums of this age mark that constant painful confrontation with the reality of their emotional and physical capacity (including their capacity to contain impulses or feelings). Such discharges are the child's means of assimilating and coming to terms with the painful reality, re-balancing autonomically. Where tantrums and tears are met either with rebuff, punishment, or a collapse in the parent's boundary setting, there is more likely to be a narcissistic split. The intensity in the body has to be deeply controlled or dissociated from, either because its prohibited or because of the fear engendered by not having either internal or external boundaries to modify the sympathetic over-charge.

Earlier on I linked omnipotence with the sympathetic state &endash; one of the characteristics of high sympathetic arousal is that sense of 'I can do anything'. And in extremis, human beings can really push up against the limits &endash; sporting activity, the movement arts, moments of heroic transcendence can give us the sense that we can be superhuman. It can be an addictive state &endash; the adrenaline addiction, which fuels omnipotent fantasy. I think the changes in Western life in the last three hundred years have accelerated and amplified an innate human tendency towards omnipotence. Three hundred years ago the sheer arduousness of life, the dependency on nature and natural cycles, the limitation of medicine, the religious structure which separated notions of man and god, kept us anchored in physicality, and in the balance of sympathetic and parasympathetic.

Nowadays we can transcend so many limits of physical reality, that it is becoming the hallmark of our era &endash; virtual reality. We are being speeded up with cultural demands to do it better, quicker, bigger, to over come previous limits. We are adapting to high speed &endash; phone, email, cars, planes &endash; autonomically, but then when these systems fail (computer crash, traffic jam), we have to very abruptly shift down in gear and re-orient. No wonder there are outbreaks of road rage ! For to cope effectively we need to be superbly autonomically flexible to adjust to the variations in pace and their implications. I suggest that as well as looking at individual histories of illness, we need to understand many of the new illnesses, especially the increasingly common autoimmune illnesses as a symptom of a larger crisis and transition. There is a creativity in these responses, as well as pain and suffering. Just as there are extraordinary developments and achievements which are stemming from broad cultural changes.

It's very hard to find a simple language to talk about complex processes and not fall into the dualisms. Because it's a system with two branches, my talk has been structured around binary pairs, but I hope it's also clear that &endash; via splitting &endash; the binary process becomes a complex analogic pattern. I don't really like words like bodymind or psyche soma &endash; partly because they are tautological, and also because of their associations &endash; bodymind sounds rather New Agey, and psychosomatic seems to imply that there is a category of illnesses which can be separated off from organic illness. I'm dubious about that. I've gone with the word organism because it implies the functional identity of mind and body &endash; the disadvantage is that it then disavows the pervasiveness of splitting as a fundamental aspect of human function. On the other hand the word environment fortuitously implies both the emotional environment &endash; thanks to Winnicott &endash; and the physical, and economic, political and social environment with which the individual is having to contend. To give an example &endash; hot flushes, hyperirritability, difficulty sleeping, mood swings. These are the symptoms of menopause. A woman's experience of menopause - which is of course a hormonal change but affects and is affected by the autonomic nervous systems as well &endash; will be influenced by her own social, cultural and personal context, as well as her diet and lifestyle.

I want to conclude this part by going back to the quote from Reich: "The development of character is a progressive unfolding, splitting and antithesis of simple vegetative (i.e. autonomic) functions". Reich thoroughly grasped the paradox of the body-mind relationship: in ideal conditions, mind and body form a functional identity (in which feeling and thinking are informed and enriched brain-body processes); however, the vicissitudes of life engender deep and multiple processes of splitting within the organism, to the point where body systems and sub-systems act antithetically, i.e. in conflict. Reich's insight stemmed from his observation that pulsation was the primary regulating mechanism of organisms. He was not so interested in the intricate emotional regulation between the infant and its caregiver. Allan Schore's work, which spans an incredible breadth of contemporary sciences, comes also to the conclusion that self-regulation is fundamental, but he integrates into this model the complexity of object relations. I find that Reich's phenomenological appreciation of psychological process and his bold formulations both challenge and complement Schore's landmark work.

Allan Schore will be giving a lecture on 'Neuroscience: why should therapists be interested?' at 7pm on 9th July at Friends Meeting House, Euston Road, London. Contact Amy Band at UKCP for details: 020 7463 3002

Part two: the therapeutic implications - including the body in psychotherapy.

(This was not part of the talk I actually gave on 26th March for Confer, but it addresses some of the issues raised by the model I am proposing)

A few notes�

* Object relations are embodied:

- chronically in changes in structure/function

- acutely as charge in the transference relationship

The therapist can work towards supporting emotional self&endash;regulation by providing boundaries, meeting the charge in the transference, and increasing capacity for insight (itself a mini-cycle).

'Charge' relates to the intensity of a process, often indicating unconscious transference feelings. It is perceivable in the body in increase/ sudden decrease of tension, significant gestures, micro-gestures, changes in skin colour and breathing etc, as well as in language and attitude. It is palpable in the countertransference. (The concept of charge has been developed at The Chiron Centre for Body Psychotherapy, in the context of integrating body psychotherapy with object relations)

� In contemporary body psychotherapy, the body is seen as both 'id' ie. the

source of primitive impulses and 'ego', ie the more or less conflicted container. We work to develop and establish the containing function of the body in and via the transference relationship. The individual's relationship with their body is itself a repetition of an earlier object relationship. (see Totton, Soth)

� The conscious embodiment of feelings in the transference relationship can act cohesively and support autonomic re-balancing. ANS responsivity and robustness in the therapist contains intensity in the client (especially at high points of sympathetic and parasympathetic activation).

� Surprise/shock/spontaneity manifest directly in the ANS and mark the impact on the organism of the environment and/or the unconscious. Intellectual activity may be part of elaborating an autonomic process OR a defence against the intensity of feelings, and shock/surprise/ spontaneity.

� Sensory-motor integration & body awareness:

- sensory functions can be developed through sensing and exploring imagery (including dreams)

- motor functions can be developed via exploring movement, gesture and posture

e.g. In the client with the frozen shoulder I might have arrived at the interpretation of the introjected cold shoulder&endash; which did have the effect of shifting the symptom &endash; just through reflection and my own experience of the transference-countertransference. However, the contribution of the bodywork was the deepening of the client's sense of her own inhibition and pain. Also, holding of her head affected her at a level where she could experience her vulnerability and need of contact, and therefore prepared the way (softened the defences against) the interpretation of loss.

� Working with physical symptoms:

- When did it/they start?

- Be curious about all aspects of the symptom. Explore what gets in the way of curiosity.

- The relationship of the client to the symptom parallels the early object relationships. E.g. is the illness an 'it'? nothing to do with 'me'? is it seen as persecutory? Is it tended to over protectively, ignored, denied, abused, idealised? Some illness can be treated as a vocation, as a calling from God.

- What is the symptom expressing in the transference?

- How is the symptom containing the wider environmental challenge to the organism?

- How can the symptom be more fully experienced?

A post-graduate course on Working with Psychosomatic Symptoms will be run by Margaret Landale at the Chiron Centre for Body Psychotherapy

Case study

Megan left her long-term partner eighteen months ago. For two years

preceding the final decision she had ongoing pain in her kidneys, a constant dry mouth and a knot in her stomach. She had been in turmoil daily with the question of whether to leave her therapist or her partner, Jane. She took up running, which she found relieved some of her symptoms. In the transference she had a sullen but stifled hatred of her therapist. She set a date to finish her therapy but changed her mind when, as she saw it, her therapist really stood up to her. She described that decision as being like a great ocean liner turning. Six months later she left Jane &endash; and experienced exhilaration and intense fear which she compared to jumping off a cliff.

Over the next year, as she struggled with housing and financial problems, and changes at work, she experienced severe stress symptoms &endash; frequent sweating, palpitations, insomnia, but the old symptoms disappeared. These bodily changes reflected the difference between a suppression of the flight reflex which led to symptoms of kidney dysfunction (pain, dryness), to the adrenaline being released to fulfil its natural function of flight. Despite the stress symptoms, there was an enormous overall improvement in her energy and health accompanied by a deep shift in her resourcefulness. As she allowed herself to depend more on her therapist, her process moved from 'dry' (sullen, stuck) to 'wet' (fluid, high emotional charge), both physiologically and transferentially. She began to use her therapy to contain intense feelings of panic, loss and rage, as well as desire and hope.

Bibliography

Body Psychotherapy

Boadella, D. (1987) Lifestreams: An Introduction to Biosynthesis (Routledge, London)

Boadella, D. (1997)' Awakening sensibility, recovering motility: psycho-physical synthesis at the foundation of body psychotherapy: the 100 year legacy of Pierre Janet (1859-1947) in International Journal of Psychotherapy, vol 2, no.2

Boyesen, M.L. (1974)'Emotional Repression as a Somatic Compromise: Stages in the Physiology of Neurosis' Energy and Character, vol 5, no 2

Reich, W. (1973) The Function of the Orgasm (Reprinted Souvenir Press, 1983)

Reich, W. (1972) Character Analysis (Reprinted Farrar, Strauss and Giroux, New York, 1990)

Rothschild, B (2000) The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment (Norton, London)

Soth, M. 'Body/Mind Integration. AChP Newsletter, nos 17,18,19

Staunton , T (ed) (2001) Advances in Body Psychotherapy (Routledge)

Totton, N. (1998) The Water in the Glass: Body and Mind in Psychoanalysis (Rebus

Press, London)

Anatomy & Physiology

Cohen, B.B. (1993) Sensing, Feeling and Action (Contact Editions)

Hartley, L (1994) The Wisdom of the Body Moving (N.Atlantic Books)

Juhan, D. (1987) Job's Body: A Handbook for Bodyworkers (Station Hill)

Kapit, W. (1987) The Physiology Colouring Book (Harper Collines, New York)

Neuroscience & Psychoanalysis

Damasio, A. (1999) The Feeling of What Happens: Body, Emotion and the Making of Consciousness (Heineman, London)

Damasio, A. (1994) Descartes Error: Emotion, Reason, and the Human Brain (Putnam, London)

Freud, S. (1950[1895]) A Project for a Scientific Psychology SE.1

Grinberg, L (1977) New Introduction to the work of Bion (Aronsom, New Jersey)

May, R. (1977) The Meaning of Anxiety (Simon and Schuster)

Moore, M. S, (1998) 'How can we remember but be unable to recall? The complex functions of multi-modular memory' in ed. Sinason, V. Memory in Dispute (Karnac)

Schore, A (1994) Affect Regulation and the Origin of the Self (Lawrence Erlbaum, Hove)

Solms, M. & Kaplan-Solms, K. (2000) Clinical Studies in Neuro Psychoanalysis (Karnac, London)

Psychosomatics

Broom, Brian (1997) Somatic Illness and the Patient's Other Story (Free Association)

Mindell, A (1982) Dreambody (Sigo Press)

Whitmont, E.C. (1993) The Alchemy of Healing: Psyche and Soma (N. Atlantic Books)

Scientific background: Chaos & Complexity Theory

Capra, F. (1996) The Web of Life: A New Understanding of Living Systems (Anchor Books, New York)

Coveney, P & Highfield, R (1995) Frontiers of Complexity (Faber, London)

ANS.html

For application form, detailed syllabus and reading list, email me at thinkbody@lineone.net or phone

the Chiron Centre for Body Psychotherapy 0208 205 2253

fragmentation, I want to briefly go back to the characteristic defences and ego capacities which correlate with these two modes. I want to emphasise that these links I am making between autonomic states and defences are not fixed, and cannot be diagnostically isolated but perceived as part of an energetic pattern. They represent tendencies; autonomic states, as I have suggested, can overlay each other and fluctuate in ways that defy simplistic categorisation.

Sympathetic Parasympathetic

Flight Collapse

Aggression Passivity

Opposition/reaction formation Collusion/retroflection

Blame others Blame self

Hyperactivity Hyperreflective

(productivity without creativity) (creativity withoutproductivity)

Projection Introjection

Omnipotence Omniscience

Mania Depression

Self-Regulation: A Developmental Perspective

Four types of Autonomic Dysfunction

Sensory Motor Functions and Splitting

Part two: the therapeutic implications - including the body in psychotherapy.

(This was not part of the talk I actually gave on 26th March for Confer, but it addresses some of the issues raised by the model I am proposing)

A few notes�

* Object relations are embodied:

- chronically in changes in structure/function

- acutely as charge in the transference relationship

The therapist can work towards supporting emotional self&endash;regulation by providing boundaries, meeting the charge in the transference, and increasing capacity for insight (itself a mini-cycle).

'Charge' relates to the intensity of a process, often indicating unconscious transference feelings. It is perceivable in the body in increase/ sudden decrease of tension, significant gestures, micro-gestures, changes in skin colour and breathing etc, as well as in language and attitude. It is palpable in the countertransference. (The concept of charge has been developed at by Michael Soth at The Chiron Centre for Body Psychotherapy, in the context of integrating body psychotherapy with object relations)

� In contemporary body psychotherapy, the body is seen as both 'id' ie. the

source of primitive impulses and 'ego', ie the more or less conflicted container. We work to develop and establish the containing function of the body in and via the transference relationship. The individual''s relationship with their body is itself a repetition of an earlier object relationship.

� Sensory-motor integration & body awareness:

- sensory functions can be developed through sensing and exploring imagery (including dreams)

- motor functions can be developed via exploring movement, gesture and posture

� Working with physical symptoms:

- When did it/they start?

- Be curious about all aspects of the symptom. Explore what gets in the way of curiosity.

- What is the symptom expressing in the transference?

- How is the symptom containing the wider environmental challenge to the organism?

- How can the symptom be more fully experienced?

A post-graduate course on Working with Psychosomatic Symptoms will be run by Margaret Landale at the Chiron Centre for Body Psychotherapy

Case study

Megan left her long-term partner eighteen months ago. For two years

Bibliography

Body Psychotherapy

Boadella, D. (1987) Lifestreams: An Introduction to Biosynthesis (Routledge, London)

Boyesen, M.L. (1974)'Emotional Repression as a Somatic Compromise: Stages in the Physiology of Neurosis' Energy and Character, vol 5, no 2

Reich, W. (1973) The Function of the Orgasm (Reprinted Souvenir Press, 1983)

Reich, W. (1972) Character Analysis (Reprinted Farrar, Strauss and Giroux, New York, 1990)

Rothschild, B (2000) The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment (Norton, London)

Soth, M. 'Body/Mind Integration. AChP Newsletter, nos 17,18,19

Staunton , T (ed) (2001) Advances in Body Psychotherapy (Routledge)

Totton, N. (1998) The Water in the Glass: Body and Mind in Psychoanalysis (Rebus

Press, London)

Anatomy & Physiology

Cohen, B.B. (1993) Sensing, Feeling and Action (Contact Editions)

Hartley, L (1994) The Wisdom of the Body Moving (N.Atlantic Books)

Juhan, D. (1987) Job's Body: A Handbook for Bodyworkers (Station Hill)

Kapit, W. (1987) The Physiology Colouring Book (Harper Collines, New York)

Neuroscience & Psychoanalysis

Damasio, A. (1999) The Feeling of What Happens: Body, Emotion and the Making of Consciousness (Heineman, London)

Damasio, A. (1994) Descartes Error: Emotion, Reason, and the Human Brain (Putnam, London)

Freud, S. (1950[1895]) A Project for a Scientific Psychology SE.1

Grinberg, L (1977) New Introduction to the work of Bion (Aronsom, New Jersey)

May, R. (1977) The Meaning of Anxiety (Simon and Schuster)

Moore, M. S, (1998) 'How can we remember but be unable to recall? The complex functions of multi-modular memory' in ed. Sinason, V. Memory in Dispute (Karnac)

Schore, A (1994) Affect Regulation and the Origin of the Self (Lawrence Erlbaum, Hove)

Solms, M. & Kaplan-Solms, K. (2000) Clinical Studies in Neuro Psychoanalysis (Karnac, London)

Psychosomatics

Broom, Brian (1997) Somatic Illness and the Patient's Other Story (Free Association)

Mindell, A (1982) Dreambody (Sigo Press)

Whitmont, E.C. (1993) The Alchemy of Healing: Psyche and Soma (N. Atlantic Books)

Scientific background: Chaos & Complexity Theory

Capra, F. (1996) The Web of Life: A New Understanding of Living Systems (Anchor Books, New York)

Coveney, P & Highfield, R (1995) Frontiers of Complexity (Faber, London)

The Motoric (Muscular) Ego:

What we can learn from the parallel and paradoxical functions of both muscle and ego

Introduction

"Mental capacity develops on the basis of the mind's recognition and awareness of physiological function. The physical body is the prototype." (Gaddini)

This chapter brings together biological, neurological, developmental and psychological theory to extend and illuminate a concept fundamental to body psychotherapy: the muscular system as the motoric ego. Body psychotherapy has always based its understanding of the psyche on a knowledge of physical function. As developmental theory (itself a multidisciplinary field) advances, this deepens and affirms the concept of a body-mind. In the first two sections I have highlighted key aspects of biology, neurology and development, that reflect the current state of research and theoretical modelling, drawing particularly on the work of Deane Juhan in Job's Body: a Handbook for Bodyworkers and the work of Bonnie Bainbridge Cohen, in her own words in Sensing, Feeling and Action, and in Linda Hartley's Wisdom of the Body Moving.

Tracing the evolution of the concept of muscle as the embodiment of certain ego functions, the third section is a concise history of contributions from Wilhelm Reich through to the integrative model taught at Chiron. The fourth section interweaves the theory from these different disciplines into a series of reflections on muscular themes, which reveal the paradoxical qualities of both muscle and the motoric ego.

The full complexity of the parallel functions of ego and muscle are explored at the end of this chapter. At this point I want to make a preliminary comparison. Muscle is the fundamental structuring, mediating, enabling tissue in the body - it is nourished by the organs, underpinned by bones, enveloped by skin and connective tissue, and enlivened by the bodily fluids. The infant and child's muscle is developed through contact with the world, and in relation to space, and objects. Ego, in the history of psychoanalysis, has been conceived as a mental structure - defined in widely differing ways - which reflects the individual's habitual adjustment to the external world. It incorporates early developmental experience (as introjected objects), and holds at bay the drive demands of the id. It is the basic premise of body psychotherapy that ego functions are body-mind processes, with the cognitive element being one side of the coin, whilst sensory, motoric capacities are the other side. The health of the ego is manifest in stability and flexible capacity; in its neurotic state the ego capacities become rigidified, even frozen. The fixed ego is reflected in character structure, and this, as Reich pointed out, is directly embodied in the musculature (and, indeed, throughout the body systems).

The Biological Function of Muscles

Movement - muscle mechanics

Muscle is designed for movement and is known as the motor system. The qualities and tone of our individual muscles are reflected in our posture and actions, from the minutest movement to our broadest gestures. Muscle accounts for 70-85 % of our body weight, and defines our size, contour, and feel. In addition, the musculature helps generate heat in the body: 70% of the energy produced by the muscles is released as warmth which permeates the body.

There are three kinds of muscle: the muscle of the viscera, known as smooth muscle; cardiac muscle; and skeletal muscle. Skeletal muscle is known as striated muscle and it consists of elastic fibres bound together in bundles. These are bound together by a thick band, usually spindle shaped and contained in a membranous sheath. This sheath is extended at the end to form strong fibrous bands known as the tendons which fasten muscles to bone. In conventional physiology muscle are considered to work in pairs, or groups of pairs: the prime movers initiating or maintaining a movement and the antagonists opposing or holding in check that movement. Movement happens when one pair contracts,and the opposing muscles lengthens.

Movement as Active Perception, Movement as Cognition

Animation - having the capacity to move - derives from the Latin word animus, meaning consciousness.

Muscle enables movement. Even sense organs, for example the eyes, rely on the exquisite organisation of tiny muscles to function effectively. Sight is affected by muscles in and around the eye, the eyelids, forehead, and tear glands, as well as the deep muscles at the base of the occiput, and all the muscles which orient the head in the direction of what is being looked at. Theorists of embodied experience, Bates, Kelly, and Lowen believe that myopia is largely the result of traumatized eye muscles, and that when the trauma or conflict is resolved, the muscle of the eye are then freed to develop and form in a more natural, vital fashion". (Dycht, 227)In this sense the capacity to look - to select and focus visually &endash; is intrinsically connected to muscle and emotion.

In the redefiniton of cognition by Maturana (Santiago theory) it is conceived as an integral part of the way a living organism interacts with its environment, including the instinctive movements (reflexes) and responses. As Capra summarizes it in The Web of Life, "in all these cognitive processes, perception and action are inseparable" "(Capra, 268). From a different base of knowledge and experience, Bonnie Bainbridge Cohen, a pioneering movement therapist, asserts:

"movement is a perception....it is the first perception to develop (the vestibular nerves, which register movement, are the first to myelinate in utero) and therefore the most important for survival;...as each experience sets a baseline for future experiences, movement helps to establish the process of how we perceive;....how we perceive movement becomes an integral part of how we perceive through other senses." (BBC, 114)

Metabolism - energy conversion

Our musculature is the largest and most metabolically active organ of the body. It metabolizes through movement. Nerve stimuli cause the muscles to contract, and this causes chemical changes in the muscle. This combines with the flow of blood to the muscle bringing nutrients, oxygen and hormones. Deane Juhan compares muscle to liquid crystal because of its characteristic capacity to change rapidly from sol (fluid, ie. flaccid) to gel (flexed): its transformations produce a 'tapas' of textures

"concentrating on the muscles, I was amazed to feel the change in pulsation when she simply imagined moving.....it was during this exploration that I got the sense of body as tapas and how assessing the muscles in terms of different foods actually helped me as a way into working. As I remember the image of her tibialis anterior as uncooked aubergine, it is as if I am physically feeling it again." (massage student, palpating muscle)

The process of shortening and lengthening affects the muscles ecology by pumping fluids. When a contraction is held for an extended period, the pump becomes a squeeze and fluid delivery is decreased. This causes hormonal and chemical deposits to build up. In addition continued contraction of a muscle constitutes 'work' and therefore uses energy: sustained tension is exhausting.

Neurological levels - an orchestration

Muscle activity has the unique property of being mediated by the voluntary nervous system, unlike other organs and tissues, making it the closest of body systems to consciousness. In fact the muscle system is a convergence or coherence zone for all levels of brain functioning, from automated reflexive responses to highly tuned skills. The cerebellum (or brain stem) the oldest part of the brain, is important for automated or instinctual movements, such as sucking. It is heavily dependent on sensory feedback. Meanwhile the basal ganglia, within the brain stem, governs rhythmic and ballistic movement. It is made up of different parts, which keep each other in check. When dysfunctional it results in wild, involuntary movements, or the opposite, muscle rigidity and tremor.

Meanwhile the cortex, the outer and most recent evolutionary layer of the brain, relates to more complex and less stereotyped muscle behaviour, such as manual dexterity and speech. The supplementary motor and lateral premotor areas - parts of the cortex - dominate when conscious control is required, and can override signals from the brain stem. On the other hand, once certain skills are learned, or habits acquired, the cerebellum and basal ganglia can take over these activities, freeing up the cortex for other roles. Juhan highlights the significance of these two motor systems - the alpha, originating from the cortex, and the gamma, from the brain stem - whose interrelationship, both sensory and functional, underpins the complexity of our conscious and unconscious movement. The need and capacity for adaptation and expression in the variety and intricacy of physical and emotional environments which humans inhabit is reflected in the incredible range of the human movement repertoire.

Proprioception - the instant 3-d map

Proprioception means 'to receive oneself'. Proprioception means 'to receive oneself'. Effectively, groups of receptors act as an ensemble providing a sensory map or picture of movement. Golgi tendon organs measure tension values and effort. The muscle spindles are sensitive to the slightest changes in lengthening or shortening of the muscle, and the speed at which these are occuring. Other receptors note joint position, and changes in pressure in the body tissue. This map is dynamic, dense, and detailed; it continuously records changes in position, movement and tension of the total muscular systemAll this information is integrated to provide a substantial, three dimensional sensory picture - like a felt hologram - which creates a background depth which we experience as a sense of embodiment. By contrast, states of dissociation and depersonalisation, where 'reality' is felt as thin and alien, reflect severely decreased integration of proprioceptive signals. The extensive implications of the bodies' capacity to internally represent itself - of which muscular proprioception is a significant part - are currently being integrated into neurology and cognitive psychology: science is able now to provide the most detailed explanation for how we feel and think through our bodies.

Although science is now catching up, Bonnie Cohen confesses, "it is fascinating...and frustrating to me that the sensations of movement and visceral activity have been excluded from the "5 senses". As all sciences are reflections of the socio-political -religous ideas of their time, it is appropriate that the historical repression of bodily sensation in Western Culture has been transmitted as a matter of scientific fact." (BBC 114)

Learning and sensorimotor integration

This sensory map influences the motor system in two ways: adaptation/motor learning (long-term influences) and immediate adjustments to movement. In addition to proprioception, vision, hearing and cognition are crucial to motor learning. Initially, vision may have a dominant role over proprioception, ie. direct observation or a visual image will accelerate the learning of a skill. But once a movement is memorized the dominance of vision is reduced in favour of proprioception. Experiences with strong emotional significance are almost always transferred from the short- to the long-term memory, along with the muscle patterns they stimulated.

Many motor activities do not rely on instantaneous feedback but adjust to previous sensory input, stored in the form of sensory engrams, in other words, habitual patterns. Proprioceptive feedback itself is not neccessary for us to carry out movement. Crucially, however, in the absence of proprioception, the motor system is incapable of controlling fine or new learned movements, or of improving these movements. (78L) In other words, for change to occur, sensory feedback is vital. The body needs to know itself, in order to transform fixed patterns.

"Learning is the opening of ourselves to the experience of life. The opening is a motor act; the experience is interaction between motor and sensory happenings." (BBC, 118)

"Voluntary" is relative

Adaptation (survival) and expression are an emergent property of neural processes becoming synthesised through the muscular system. In evolutionary terms, muscle links us with animals, which, like us, can run, bite, grip, communicate through vivid language of movement and expression. But development of the neo-cortex also means we can suspend, suppress and distort or reformulate instinctual behaviour. A clash of needs and perceptions internally may create manifold and contradictory mental and muscle impulses.

I could not tell I had jumped off that bus,

that bus in motion, with my child in my arms,

because I did not know it. I believed my own story:

I had fallen, or the bus had started up

when I had one foot in the air.

I would not remember the tightening of my jaw

the rage that I'd missed my stop, the leap

into the air, the clear child

gazing about her in the air as I plunged........

Sharon Olds, 53

To the extent that there is integration between systems, we have the symphony of grace, purpose, congruence. Failures of integration - from normal to extreme - diminish our sense of ourselves and reflect our painful, complex and individual circumstances and history.

Although we talk of 'voluntary' muscles, and the cortex is associated with 'conscious' activity, these assumptions are misleading. Learned behaviours are initiated and controlled by engrams or gestalts, memories of how specific actions have felt. "These sensory memories function more like blueprints, or templates, than they do like a linear sequence of commands....each quantum of engrammatic memory contains the whole of a particular movement [...] stored as an image or outline." (Juhan, 289)

We may think we are choosing an action deliberately, but how we actually act is the sum of our history. And we can perform quite significant and complex actions whilst being unaware that we are doing so, like the driver who is surprised to realise he has navigated his way to a particular place whilst his mind was 'elsewhere'.

Development

Developmental Stages

Muscle is literally developed through contact with the world. In the beginning the uterine environment offers the baby resistance to its own movement, as well as offering the experience of the mother's movements. This is followed by birth which requires powerful physical effort and an immense act of will on the part of the birthing child. "As the head of the birthing child pushes into and through the birth canal and the tail of the spine and the feet respond by pushing against the contracting walls of the womb, the push of the head transforms into a reaching through to the new world outside." (Hartley, 53)

The development of voluntary - as opposed to reflexive - muscle activity happens in a precisely differentiated sequence. Learning gross and fine motor control takes place intensively in the first seven years - sucking, manipulating objects, rolling, crawling, walking, speaking, writing - but continues to be refined throughout latency, adolescence and adulthood.

When the bare feet of the baby beat across the grass

The little white feet nod like white flowers in the wind,

They poise and run like ripples lapping across the water

Lawr.38

Muscle, brain and ego development are inseparable, and depend on sensory and relational (human) feedback: "the greatest sensory motor organisation occurs during adaptive response....each adaptive response leads to further integration of sensations....[and] leaves the brain in a more organised state." (March, 54) The acquisiton of new skills leads to a sense of mastery, and an increase in the capacity for reality testing, which strengthens the ego. Common phrases about being able to "handle" life, or "get a grip" or "put the best foot forward", and "take a step in the right direction" sum up our intuitive understanding of this connection. illus.ground1.tif

Knowledge is only rumour until it is in the muscle

-New Guinea proverb

Challenge and new input are vital to further development. However, trauma and high levels of stress reduce the sensory field, which is a key integrating system. Deficits and traumatic interactions appear as a disturbance or imbalance in tonicity of specific muscle groups, which affect the final shape, movement, and style of the adult body.

Tone

Tone means pitch or tension, and refers to the resting state of muscle: it expresses the readiness of the muscle to act, to respond, to relate. Hypertonus refers to highly toned or tense muscle; hypotonus refers to low tone, or slackness. illus.bab1.tif Tone is a product of the interplay of : the health and maturity of the organs; the quality, or lack, of dynamic support; the child's degree of mobility; and continuity of or interruptions to meaningful emotional contact. Tone develops from using the muscles and for this the infant requires motivation, desire, and attention. The dynamics of meeting, overcoming, yielding to gravity and balancing resistance - gained through play with others and exploring a diverse and structured environment - are vital food for the developing muscles. The weight of the body being moved through space becomes the resistive force which increases the strength and support of the larger, more powerful muscles.

"Postural tone begins to develop in utero....after birth, the tone continues to be a response to gravity and is further modified by the way we are related to physically, perceptually and emotionally. Tone is relative and is reflective of the interaction between one's inner and outer environment." (BBC, 125)

Flexion/Extension

Flexion is the characteristic state of the infant in utero, where the flexor muscles on the front of the body are toned so that the body is curled up. Outside the womb, the developmental thrust is towards extension, with the extensor muscles of the back gaining tone until the point when the infant can fully arch. This basic process overlaps with the gradual individuation of flexion and extension in each limb. This develops through the emergence of the reflexes, equilibrium responses, and the acquisition of motor skills. A balance between flexor and extensor muscles is reflected in good overall tone and a sense of being grounded. Too much tone in flexors either manifests in the tendency to curl up, or in a compensatory attitude in the extensors, a braced attitude.

Flexion and extension underlie our most basic expressive movement patterns. Flexion suggests containment, contraction, closing, hiding, protecting, retreating, defending.

Extension implies expansion, opening, reaching, pushing, showing, exposing, moving outward/ toward. (illus.dance2.tif)

Flexion...... Extension

You lie, snail-like, on your stomach - The authentic! It rolls

I dare not speak or touch, just out of reach, beyond

Knowing too well the ways of our kind- running feet and

The retreat, the narrowing spiral stretching fingers

Wendy Cope, 'Depression' Denise Levertov, 'Matins'

The Psychological Function of Muscle

A Historical Perspective:

Wilhem Reich - Muscle armour and character

Wilhelm Reich, the father of body psychotherapy and a major influence on the development of bodywork, was the first to postulate a direct connection between musculature and psychological function. "Muscular rigidity....represents the most essential part of the process of repression ....and is the basis of its continued preservation." (FO, 39) Muscle rigidity became known as armour, and its function, according to Reich, was to bind or block "basic biological excitations", such as anxiety, hate or sexual feelings. It is the functional equivalent of the ego's binding of unacceptable impulses. Its origin is in the infant or child's habitual inhibition of impulses and expressions of feeling in situations of unpleasure, typically the disapproval of its parents and significant others. The child learns to tense the muscles to hold back the movement or feeling - whether it is a facial expression, or an undesired behaviour - and when this is done repeatedly, the muscular holding pattern becomes chronic and unconscious. Reich's emphasis was on repression, but of course, the muscular responses to neglect are equally imprinted, often as collapse, as undertoned muscle.

The muscular inhibition of an impulse is a concrete and visible manifestation of the parental or environmental prohibition. It is the physical manifestation of the process of introjection. (Johnson, p.68)

Reich characterised muscular armour as being divided into seven horizontal segments, from the ocular segments to the legs, depending on the emotional function of each area. He also recognised how an individual's muscular armour carried the nuance and idiom of his sense of identity. He described a patient whose "reserved countenance...noble stride and... patrician bearing" was very striking. Reich told him that he was playing the role of an English lord, and this led directly to the patient's revelation of a long-standing fantasy that he had an aristocratic lineage, in contrast to his status as the son of "an insignificant Jewish merchant". (FO, 194-5) In this example the identity has a defensive function correlative with the patient's attempt to remain "above it all", ie. on top of his feelings. Today we might also note that the fantasy is also an effect of internalised anti-Semitism. "Every muscular rigidity contains the history and meaning of its origin."(FO )

The direct manipulation of the muscles, including pressure on muscle insertions, became an intrinsic part of Reich's characterological work. Supported and interwoven with verbal analysis, this helped support vegetative changes, cathartic release - such as sobbing or shouting - and softening and enlivening of the musculature. Reich's language of therapeutic "attack" and "breaking down defences" comes across today as inappropriately aggressive, but the basic principle of addressing muscular armour as part of a broader therapeutic endeavour has had a far reaching influence.

The Biodynamic model:

The startle reflex and the somatic compromise

Boyesen recognised the activation and incompletion of the startle reflex as an important pattern underlying habitual muscular contraction. (see Bones chapter) The inhibited reflex results in contractive patterns retained as micro-gestures. This is the startle remnant, which co-exists with the maintenance of a tendency to hold the diaphragm in an inspiratory tension, and other vegetative holding patterns, to create what Boyesen called the somatic compromise. In extreme cases, the gesture, such as ducking the head, and moving the shoulders forward to protect the heart, is visibly reified in the musculature.

Boyesen emphasises that the failure of the parental environment is a key factor in the development of the somatic compromise. Both Reich and Boyesen focussed on the effects of repressive parenting on children, but paid less attention to the infant's need for holding, before they have attained significant voluntary muscle activity. Falling anxiety - which can relate to the absence of good enough psychological as well as physical holding - can set up some of the deepest patterns of underlying muscular rigidity. David Boadella writes, "how we handle the infant in these first early hours and days establishes basic patterns in how he holds his body, his muscular organisation as he resists and opposes or surrenders to gravity." (Life, 59)

The Motoric Ego

In the biodynamic model the musculature became more broadly associated with ego function and self-regulation: "the ego regulates the id's vertical upsurge by means of the horizontal counterforce of the bodies' musculature". (Clov,INN) The muscles are seen as a structural container. 'Horizontal' functions are to do with agency, the ability to translate ideas into action, to interacting in and with the world. The muscular system embodies the 'motoric ego' . The 'vertical', embodied in the alimentary or 'id-canal' is the instinctual force of feeling and impulse. Ideally, vertical and horizontal work together in 'dynamic equilibrium', creating psychological, physical and energetic balance, reflected in good muscle tone. As Boadella phrases it, "the inner organ language of the vegetative system" is integrated with "the outer muscle language of the muscular-skeletal system" (Roots, 17) This constitutes ego-strength, a psychological term to which Gerda Boyesen gives a physiological dimension.

Where the ego has a pseudo-strength - ie. the person has a capacity to act, and to do, but little sense of sponteneity or meaning - this is reflected in rigid muscles. There may be heavy armouring in places of the body to which expression has been denied. By contrast, the ego weak person is overwhelmed by the feelings and impulses of the id, and has difficulty containing the charge or bringing it to fruition in the world. He or she is ungrounded, finding it hard to focus and identify needs, and easily thrown off balance. From Lilemor Johnson, Gerda learned about the underdevelopment of muscle which relates to problems in early development, and this is reflected in the ego weak person's flaccidity of muscle and tendency to collapse. Low muscle tone is related to over-active or compensatory fantasy; high muscle tone is related to control.

[extend Johnson?]

The Bodynamic concept: muscle as a resource

At the Bodynamic Institute in Denmark, Lisbeth Marcher has integrated Reich's and Johnson's discoveries, with an in-depth understanding of psychomotor development. She emphasises that sensory -motor development takes place in relation to people and the environment. For the growing infant and child, each new level of development, new motor capacities provide possibilities for new sensory experience, new perspectives, and new possibilities for interacting with the world. In addition, for the ego to develop, "the child needs to acquire forms for the containment of energy, for protecting the self against overwhelming external stimulus and for distancing the self from internal stimulus that cannot be regulated." (Marcher, 59) Muscles are thus understood as being a resource which enable motor activity, containment, self-regulation and reality testing.

The sequence of muscle development is quite specific, and Marcher has developed a diagnostic technique called 'body mapping', which consists of testing the major muscles for their hyper or hypo responsiveness. It is based on the notion that muscles have a dual response to stress, becoming either hyper- or hypotonic. If a stressor is relatively light or comes at an age where there has been sufficient development , the muscle is likely to become hypertonic. If the stressor is relatively massive, or is premature for a child's developmental stage, the muscle will be hypotonic. The distribution of muscular tonicity, its pattern and degree reflects each person's complex and unique history

Chiron - an integrative model

Working directly with muscle takes many forms - the use of movement, direct palpation, observation of posture etc. Within body psychotherapy, biodynamic massage is unique as a system of formal bodywork, using a table and a structured set of techniques. This naturally creates a different perspective and context from the larger scale and variety of movements witnessed in, for example, dance movement therapy, but it brings into focus parts of the body, such as the face, for close detailed work. At Chiron, biodynamic massage is taught as part of an integrative psychotherapy training which draws on the theory and practice of Gestalt, developmental models, Reichian, Jungian and Object Relations. This offers the potential to work with the client lying on the mattress, standing, moving or sitting. But the emphasis in the training is on understanding the client's habitual fixed relational postures and how these impact on the therapist through direct observation and bodily resonance (countertransference). In this sense, muscle carries the charge in the transference-countertransference relationship.

Muscular Themes

The following is a brief summary of themes, many of which have already implied in earlier sections of this chapter.

Agency/Intentionality

Intention, from the Latin, in-tendere - to stretch toward

Muscle tone and quality reflects ego capacity to the degree that we are organically organized for any given activity. This means being able to focus our attention and intention on an activity and feel adequate to the task. Muscles reflect our sense of purpose, or lack of purpose. illus. meliss1.tif

I ate the day

Deliberately, that its tang

Might quicken me all into verb, pure verb.

H 92

We can use brisk muscular activity - walking, cleaning, exercise - to shore up the ego in times of strain. Taken to an extreme, physical activity for its own sake can be mechanical, even robotic. When activity is disconnected from an inner source, we refer to 'going through the motions', a phrase associated with a person who is in shock or severely depressed. Or we may see it as manic activity, a flight from the internal world.

Optimally, muscle is a vehicle for expressing and fulfilling our selves:

The hands that hammered in those nails

emptied that kettle one last time

are these two hands

and they have caught the baby leaping

from between trembling legs

and they have worked the vacuum aspirator

and stroked the sweated temples

and steered the boat....

Rich, 9

Body Image, Identity and Identification

The mental image, or topography of the postural model of the body is continuously being constructed and destroyed. (Schilder,Levy 9)

It is not the body-object described by biologists that actually exists, but the body as lived in by the subject. (Beauvoir, 1953, 69)

The muscular system carries our ego identity in the broadest sense. How we use our muscle, our characteristic posture, gait, gesture reflects and communicates a great deal about our gender, class, race, culture, and lifestyle, as well as our developmental history. Embedded in our muscles are all the skills, habits, expressions and defences we have acquired. The range of our learning includes normal development skills, such as feeding, and walking; specific skills - such as weaving, carpentry, juggling, driving; character attitudes, such as defiance or deference; patterns stemming from trauma, including birth trauma; and identifications made with others.

Psychological identification happens to a significant extent through mirroring or mimicking another's physical stance and movements, or echoing their shape or rhythm. Identification is one of our earliest expressions of an emotional tie with another. It may be deliberate and purposeful - as when learning a skill - or it may be unconscious, stemming largely from emotional needs or defences. It is a major psychological tool of the human species, enabling us to survive, to understand others, and make connections with families or groups that we use to define ourselves.

I stamp like the bear I call like the wind of the thaw

I leap like the sea spring-running.

My sun-struck daughters splutter

and chuckle and bang their spoons:

Mummy is singing at breakfast and dancing!

20C 267

Identification has many aspects to it but to understand how muscles are involved in this process, it is useful to compare the phenomena of imprinting in animals. Imprinting was studied by Konrad Lorenz, who observed that when ducklings hatch they respond to the first thing that moves - in this experiment, him - follow it and treat it as mother. He found that if he reintroduced them to the real mother, they still continued to treat him as mother, and carried on copying his movements.

Identification complicates identity because it is multiplicitous, generating layer upon layer of history and potential. illus. head1.tif From object relations, we derive the understanding that it is not just individual figures that we internalize but actually relationships between ourselves and others. For example, a girl bullied by her elder sister may identify with her (identification with the aggressor), and carry in her body both the frightening object and the frightened one (herself). The sister's movements of swaggering, threatening, hitting are remembered internally as a particular set of movements, while the experience of being the victim is held in a feeling of being paralysed. Later in life, moving in a certain way may be unconsciously associated with power and danger, whilst being still - for example, on the massage table - may be associated with hiding.

The concept of body image explored by psychologists and psychoanalysts comes over as rather static, and overly visual. But it has highlighted our culture's narcissistic obsession with the body, and the body as battleground for control between, for example, a mother and daughter. It has been usefully taken up in art and movement therapy, as well as body psychotherapy, as a way of helping the client access and represent feelings about themselves.

Arnold Schwartenegger articulates the narcissistic attitude: You don't really see a muscle as part of you....the bicep has to be longer, or the tricep thicker...You look at it and it doesn't even seem to belong to you. Like a sculpture, you form it. (Schwartzenegger, Wood, 122)

Instinctual Patterns and Archetypes

Not all fixed patterns are limiting. The reflexes which makes you put your hands out to break a fall, or which enable you to swallow, or which sustain uterine contractions during labour are part of our human inheritance. They can be considered the physiological equivalents of psychological archetypes, deep patterns or imprints which connect us to our species and are intrinsic to survival and reproduction. A physical reflex may constitute a literal response to a tangible event, or it may appear as a form of memory (often a traumatic memory), or as a symbolic communication. Examples such as feeding, gagging or birth reflexes carry powerful object-relational dynamics, often embodying deeply unconscious statements of relationships and orientation.

Contact/Grounding/Reality Testing

"The beginning of the loss of reality testing in schizophrenia lies in a patient's misinterpretation of sensations arising in his own body." (FO, 24)

Contact and grounding in body psychotherapy are synonymous with having a felt (proprioceived) awareness of the body as an object in space and time. If we think of an animal say, a cat &endash; its well-toned muscles, orientation, balance, quickness of reflex etc are all part of its very refined and acute ability to be in its environment, in reality. The opposite of this is the psychotic state, where the person's internal state can be wildly deconstextualised, in a literal sense; they are thrown off balance, can't feel the ground under their feet. One way of bringing someone back to the present if they have been lost in a memory, or intense emotional state, is to get them to walk, to pick up an object and bring their attention to the physicality of the experience.

Flexibility/Responsivity

"Muscle is the tissue with which we surely feel the present moment. Bones grow over decades, connective tissue tends to change over months or years.But muscles can go through contraction, extension, and holding all in the course of moments" RN

Muscle is contractile and excitable and therefore instantly responsive, enabling us to move and react with skill, speed, and sponteneity. We have seen how muscular stiffness (armour) indicates an emotional inhibition, but hyperflexibility can represent the opposite polarity, "passivity and a highly emotive consciousness", a lack of internal structure and rapidly fluctuating ego states. (Maps, 38) Muscle has the function of stabilising the flow of energy, whether it is conceived of as metabolic or psychic energy. The musculature regulates through movement, or contracting against the impulse - hence the function of exercise, or compulsive actions or gestures, such as foot tapping, in 'using up' or 'diverting' psychic energy.

Containment/ Boundaries/ Interface

Muscle provides shape and structure in the body, defining and making boundaries between sections of the body, and between the individual's internal structure and the outer world. The muscular mass can provide a sense of substance and structure beneath the superficial boundary of the skin. Likewise, Reich described the ego as a "buffer in the struggle between id and the outer world". The denser the musculature the more the potential impact absorbtion (this is not just about physical density, but tone, structure et).

"The ego is as strong as the amount of energy it can meet without there being shock". (Gv, 39)

The musculature provides a crucial container for binding and organising energy, and its capacity to do so is reflected in the tonus and differentiation of the muscles. Recently developed somatic trauma work uses as one of its tools, a deliberate conscious toning (tensing) of muscle. Muscles relate to specific activities &endash; reaching, kicking, turning the head to see etc, which can be strengthened or relaxed to the point where the tone is optimum for it to contain the impulse (rather than repress, collapse or dissociate from it). It is the embodied contact (proprioceptive awareness) with the muscle and its function that supports the psychological attitude &endash; for example, sitting up straight, immediately changes the sense of self

Expression/Communication/Character

"Words can lie. The expression never lies.Although most people are unaware of it, it is the immediate manifestation of character" (Reich 19 73: 171) Or as it is put in NLP "you cannot not communicate." The totality of muscular patterns, both chronic and temporary, conscious and unconscious, creates a constant stream of information and communication. For example, we sense whether someone's smile is genuine or not. This is possible because involuntary expression is activated subcortically (in the limbic system), whilst deliberate expression is activated through the cortex, or 'higher' brain. The genuine smile actually engages an additional set of muscles around the eyes, and we intuitively know that "smiling with the eyes" indicates a deeper level of feeling than a smile which looks "plastered on." Despite the musculatures capacity to inhibit impulse, it represents as it conceals, it expresses as it defends against, and it conserves as it wards off feeling. Like a symptom.

Conflict/Splitting/tension

"Sometimes the [...] impulse and the inhibition of the same impulse can be localised in the same muscle group [....] the conflict between impulse and defence, with which we are so familiar in the psychic realm, has a direct correlation in physiological behaviour. At other times, impulse and inhibition are distributed among various muscle groups" WR 330

Muscles are constructed to work around tension, operating in complementary or opposing pairs. Feeling our muscles can give us the experiential sense of dynamism and division, force against force, as in wrestling or struggling against another, or ourselves. As we are jammed in internal conflict, the stuckness is palpable in the knots and tensions in our musculature. Muscle has a paradoxical function: it 'pulls us together' - organises us into a familiar pattern, including energetic withdrawal and binding of anxiety, rage, sadness - even as its tension embody our splits.

"There is constriction around my neck and in a diagonal line down my back. By holding certain of my muscles, I literally seem to create the physical sensation of being split off from myself.....And now...I feel a different kind of muscular patterning. I feel excited and can feel the muscles around my chest extend. The muscles in my face which control smiling are starting to contract.

I wonder is there any part of my experience which is not expressed with my muscles?"

"I notice I am straining muscles around my diaphragm, contracting muscles in my neck and high up next to my occiput. Its a feeling that I want to batten everything down .......I want to grasp the truth with my muscles."

"I feel this deep sense of habit in my muscular patterning, the sense of wanting to withdraw, and hold and contract while pushing and straining. Its all a muscular trip. I have the image of a friend smiling and feel something happening in my heart, and my face muscles contract and extend into a broad smile. My diaphragm flutters, my throat constricts again. There seems to be no ending."

Synthesis/ Integration

"The rhythmicity of one's movements, the alternation of muscular tension and relaxation in movement go together with the capacity for linguistic modulation and general musicality" (Reich, CA, 345) Just as the musculature can reflect the strain of holding together conflicted parts, so too it can embody through an individual's grace, and intricacy of movement an extraordinary synthesis of sponteneity and acquired skill.

O body swayed to music, oh brightening glance

how can we know the dancer from the dance?

In a therapeutic context there may be a 'coming together' in the client, visible in the musculature as a deepened breath, aliveness and congruence in their presence - a 'bodyshift' equivalent to, and sometimes accompanied by, a conscious insight.

Muscle and Ego: Parallel Functions

Unusually, rather than just using psychological/analytical models and clinical experience as the basis for defining ego, I have tried to extend the notion of ego by deepening my understanding of neurology and physiology, particularly of the muscle. Of course the totality of ego functions depends on the body as a whole - it arises out of the interaction of multiple systems. But the biological and developmental function of muscle has important parallels with ego, and I believe the concept of the motoric ego is sufficiently robust to bear expanding.

Muscle is the system we think of when we talk about the body working. In psychoanalysis "working through" implies the ego's struggle to integrate. Both muscle and ego go through stages of profound change between foetal life, infancy and adulthood : a development which is not just a growth in size, but the evolution to a more highly organised state. The adult ego of the mother or her substitute 'holds' the baby while it progressively learns to hold itself; the earth/floor or parent holds the baby as it lies until it is able through rolling, crawling and finally standing to hold itself up against gravity.

The analyst Micheal Balint, who was influenced by Reich and Ferenzci, and who articulated the difference between benign and malign regression, noted the parallel responses of ego and muscle to the viscissitudes of life. "When the strain is too great, the child has two ways of recovering his balance. Either his ego may be overwhelmed by the growing excitation and a state of panic sets in, which then finds relief in an outbreak of affect and unco-ordinated movements. Or else it will do its utmost and call up all his energies to stem the excitation. The first method resembles a clonic, and the second a tonic spasm [...] these two modes of reaction are the ego's primal forms of defence."

Muscle and ego both have a characteristic capacity to divide against themselves in order to hold a peripheral structure together, and protect a deeper structure. As Nick

Totton puts it, Reich's discovery was that "the ego[....] pits muscular energy against itself - using muscular tension to inhibit muscular impulse." The capacity of the ego/muscles for "interrupting, holding back [...] can be a deliberate temporary reaction or it can be a chronic fixed habitual pattern which is outside awareness. The first one is an important source of creativity (Jung's opus contra naturam). Its the latter which Reich considered to be the root of neurosis." (Soth, 17)

Bibliography

Please contact me for the bibliography.

Email Roz at thinkbody@lineone.net

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