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My therapist gently rested her hands on the top and underside of my right hip as I lay fully clothed on a massage table. Her hands remained still, drawing my awareness to a part of my body I’d never especially liked. Eyes closed, I strained to focus on the interior of my normally silent hip. “I feel heavy,” I heard myself say. “It’s like there’s an iron ball lodged in the socket.”
Focusing on this heaviness, I began to cry. My hip was suddenly much more than flesh and bone. It had become a kind of messenger: “Life is hard,” I said, “and I have to struggle to achieve anything.” I’d been on the table for just a few minutes, but I was already swimming in deep emotional waters.
I was in therapy, but a long way from the typical couch-and-Kleenex variety. Weary of listening to myself talk in traditional therapy, I had turned to a form of “body psychotherapy,” a catch-all term for dozens of techniques rooted in the belief that the body can be a launching pad for inner exploration, and that physical techniques—like gentle touch, movement, or body-awareness exercises—can help people gain insight, overcome depression or anxiety, and improve relationships.
There are more than 60 different approaches that can loosely be gathered under the heading of body psychotherapy. (See “Body Check,” below, to learn about some of the more well-known ones.) Some are more active; the therapist might have clients punch foam blocks or hold certain postures to spur emotional release. Others are more evocative, using gentle touch or body-awareness exercises to draw out memories or emotions. Many body psychotherapists practice a blend of modalities.
While some traditional talk therapists remain skeptical, supporters suggest that body psychotherapy can facilitate rapid change. Good verbal therapy can be very effective, says Alex MacMillan, director of the Center for Body Oriented Psychotherapy in Somerville, Massachusetts, but “if you want to work as efficiently as possible, you work on the body and the mind simultaneously.”
“When someone comes in with an issue, it’s an issue on all levels,” says Joel Ziff, Ed.D., a licensed psychologist and conference organizer for the United States Association of Body Psychotherapists (USABP). “We need to not exclude the body from therapy.”
Lisa, a 38-year-old marketing manager with a 10-year-old daughter, spent three years in talk therapy. Zoloft had taken the edge off her depression, but talking, she says, hadn’t unearthed all she was feeling.
“I never really felt connected to what I was saying,” she recalls. “I was keeping myself on a surface level, talking a lot about my relationships with other people, but not getting to the core of me.” When her therapist, who was training in the Rubenfeld Synergy Method, introduced the possibility of touch, Lisa says she felt relieved.
Rubenfeld Synergy Method is one of the best-known and most widely practiced evocative techniques. Rubenfeld synergists, as they’re called, use light touch to focus a client’s awareness on the sensations and energy moving through various parts of the body. Rubenfeld says synergists don’t try to “make” something happen. “We use touch with the intention of listening to the client and educating them to listen to themselves,” she says. “Our hands follow the client’s energy.”
“I lie down,” Lisa says, “and for the first five minutes or so, [my synergist] touches the base of my neck, moves my leg up and down, or stretches my arm out, checking where my tension is. Then she’ll ask me, ‘What’s going on?’”
Gentle touch, Lisa says, has helped her access her emotions more quickly and more fully. She had made contact with the “scared little girl” in her in talk therapy, but, she says, “I couldn’t gain full access to her. When [my synergist] holds my head in her hands, that opens me up so I can find her.”
The concrete benefits she attributes to Rubenfeld Synergy—greater self-acceptance and less dependence on her husband—are those one might gain from talk therapy, but, at least for Lisa, the experience is more comprehensive. “I never expected to walk out of talk therapy and feel whole,” she says, “but on the table, I expect to dig in, to do the work, to experience relief.”
For some people, the experience of body psychotherapy versus talk therapy is akin to watching a DVD instead of a video—the color is richer, the sound clearer, the experience more immediate and complete. Why the dramatic difference? Touch, contends Rubenfeld, bypasses the neocortex, the “thinking” part of the brain, and goes right to the emotions. (For those who have experienced trauma, body psychotherapy may actually release memories stored in the body; see “Overcoming Trauma,” below.)
Even the best-intentioned clients might, with language, unconsciously maintain defenses that their bodies reveal, say body psychotherapists. “It’s not enough to talk through your life issues,” Rubenfeld remarks, “because the body still retains the story of those issues. You need to hear the body’s story.”
Body psychotherapists insist that they’re not neglecting the intellect. They’re simply working in reverse order from their talk-therapy peers. Body-based therapies first engage the senses, which evoke emotions. Processing feelings and sensations in a cognitive manner is the last step.
Dr. Martha Stark, a psychoanalyst and clinical instructor in psychiatry at Harvard Medical School, has studied various body-centered therapies and says it has informed her work, though she remains rooted in verbal practice. “Good talk therapy,” she asserts, “is more than just head stuff. It works from the top down, from cognition to emotion to sensation, rather than from the bottom up. Both approaches get to the same place by way of a different route.”
In both theory and practice, however, body psychotherapy is a source of controversy. Stark says many of her peers don’t recognize the value of body-centered approaches. “Most of them don’t perceive body-oriented therapy as real therapy,” she says.
Some reject body psychotherapy because many training programs, though rigorous (some are four or five years long), do not require students to have prior schooling in counseling or psychology. “It’s a weakness in the field,” concedes Betta de Boer van der Kolk, a licensed clinical social worker and certified Rubenfeld synergist. “As a psychologist, you’re trained in how to deal with things like addiction and depression, and that’s important.”
Others simply don’t think therapists should break the taboo against touch; the risk of sexual abuse, or blurred boundaries to say the least, seems greater when physical contact enters the therapeutic picture. That’s precisely why, body psychotherapists say, thorough training and regular self-monitoring are so important.
Ziff stresses that body psychotherapy incorporates a range of techniques and does not necessitate physical contact between client and therapist. “If you have a problem with time management,” he explains, “I can ask you to take out your appointment book and tell me what you sense in your body as you do. That’s body therapy, too. It brings in data about how you function, which increases awareness.”
Who benefits from body psychotherapy? While dancers, athletes, and other kinesthetically oriented people might seem naturally inclined toward it, Stuart Black, a New York City–based body psychotherapist, says logical, analytical types are sometimes the ones who reap the greatest rewards. “People who are in their minds—brilliant people,” he says, “really benefit from this work. If they’re in verbal therapy, they can tend to stay in control and not take the journey.”
Many of them turn to approaches at the opposite end of the spectrum from evocative techniques like Rubenfeld Synergy. These more active approaches, sometimes called “provocative” therapies, stem from the work of Austrian analyst Wilhelm Reich, generally considered the grandfather of body psychotherapy. A student of Sigmund Freud, Reich believed that emotional defenses developed in childhood manifest in holding patterns in the body’s musculature. In order to loosen the armor and contact the “authentic self” within, practitioners might palpate tense muscles or have the client assume “stress positions,” postures that overload muscular holding patterns. The theory is that as muscles tire and release, the emotions embedded in the body emerge, allowing what was unconscious to surface.
A session in Bioenergetic Analysis, for example, developed by Alexander Lowen and John Pierrakos in the 1950s, or its more spiritual offshoot, Core Energetics, might have clients repeatedly strike a large foam cube with a foam bat called a bataka, jump up and down, or lie with their backs over a barrel to release blocked energy.
“I had him lie down on a mattress and begin to kick,” recalls Black, who directs the Institute of Core Energetics East in New York City, describing a session with a thirtysomething man who had difficulty expressing anger. Black gave his client permission to have a temper tantrum and say all the things he normally held in.
“The kicking put pressure on his pelvis, where his feelings were held,” Black explains. After the man tired out, Black had him hold his legs up in the air. “That released the feelings into his body,” Black continues, “and he began to cry. He didn’t realize how much pain not being able to express anger had caused him.”
Black says Core Energetics sees the human personality in three parts: the mask, the lower self, and the higher self. The mask represents the face people present to the world, a socially acceptable front that conceals the lower self, where the individual’s less-than-enlightened aspects—greed, selfishness, jealousy, etc.—reside. “The work of Core,” Black explains, “is to get out of your mask and into your higher self, the godlike part of you. To do that, you need to go through your lower self.” When clients hit the foam cube, says Black, “we want them to express their lower selves. They can do this in talk therapy, too, but if they hit first, we’ll have a deeper conversation faster.”
“Hitting the cube helps you get out of your mask and get real,” agrees Mark, a 57-year-old commercial real estate broker whose wife convinced him to participate in a Core Energetics group years back. “I’d never done therapy before—I thought I was going for one day,” he chuckles, remarking that he’s since graduated from a four-year Core Energetics training program.
Mark says the self-awareness he gained from Core is the sole reason he stopped drinking. “I haven’t had a drink in two years,” he says, “and I’d always medicated myself. My father died when I was young, so I learned how to take care of myself. I had a wall up, but Core helped me look at myself and change. I’m not the same person.”
Some body psychotherapy approaches are downright Zen—like the popular Hakomi Method, an evocative therapy developed by Ron Kurtz in the 1970s. Kurtz, who studied Taoism and Buddhism, refers to Hakomi as mindfulness-based psychotherapy.
“Change without force” is a guiding principle of the technique. If, for example, a client hikes up his shoulders when talking about his marriage, a Hakomi practitioner will not push his shoulders down, but might do the opposite—hold them up. “We like to support the ways people manage their emotions,” says Richard A. Heckler, Ph.D., director of the Hakomi Institute of San Francisco, “so they can go underneath them and explore what’s given rise to the defenses at their own pace.”
Like other body psychotherapists, Hakomi practitioners say the body is often more honest than the mind. “We don’t listen to [clients’] stories and analyze,” explains Kurtz. “That’s not a rapid route into their core beliefs. If we want to understand where clients are coming from, we watch what they’re doing. Their history is written all over them.”
“Let’s say someone tilts her head to the side whenever she speaks about her father,” Kurtz continues. “We might ask her to become mindful of what happens when she turns her head upright. If she’s attentive, she’ll notice fear, and we’ll invite her to stay with it.”
Instead of asking the client why she’s afraid (“I’m leery of questions,” Kurtz notes. “They drive people to explain”), a Hakomi practitioner might say, “You’re safe here.” When her body tightens in response to fear, “we might hold the tightness for her so she can relax,” Kurtz says. “If we take over the part that says ‘Don’t trust him,’ she might collapse and sob. All the pain and memories become available.”
Pain, however, isn’t the only emotion that reveals itself during body psychotherapy. A lively woman in her seventies began sobbing on Ilana Rubenfeld’s table during a workshop, complaining that her husband had left her after 40 years of marriage. Slipping her hands under the woman’s back and “listening” with her fingertips and her palms, Rubenfeld didn’t feel tightness or tension, but a soft back pulsating with “juicy” energy.
“I asked her what else was going on in her life right now,” Rubenfeld remembers. “She got quiet and then [explained] that she had two boyfriends who showered her with affection. She realized she felt guilty enjoying herself so much and wondered what people would think. She had a story in her head. But the truth was in her body.”
A handful of the more prominent forms of body psychotherapy are described below. The United States Association for Body Psychotherapy (usabp.org) has resources for finding a therapist in your area and guidelines for choosing a therapist.
Inspired by bodywork practices like the Alexander Technique as well as Gestalt therapy and Eriksonian hypnosis; practitioners use light touch to access emotions and memories stored in the body.
What to expect: Clients usually lie down, fully clothed, on a massage table, though sessions can be done in a chair. Synergists use light touch at points on the body—head, shoulders, hips, knees, feet—to bring clients’ awareness to sensations and energy. Images, feelings, and memories that surface become the substance of the session. Clients take a minimum of 10–12 sessions, which are usually one-on-one.
Look for: Certified Rubenfeld Synergist
Draws from Freudian theory and holds that we carry our emotional defenses in our bodies; therapists have clients hold postures and do movements to tire the muscles, thereby releasing emotions.
What to expect: Sessions may be done sitting, standing, or lying down. May or may not involve touch. Hitting foam cubes and holding stress positions are common techniques. Sessions can be done one-on-one, in couples, or in groups.
Look for: Certified Bioenergetic therapist
Offshoot of Bioenergetic Analysis, but holds that spirituality is the “core” of human experience. Practitioners help clients move through their “mask” and lower self to the higher self.
What to expect: May or may not involve touch; clients do movements and hold positions that strain the musculature and increase awareness; practitioners might pray to set the intention for the session. Can be done one-on-one, in couples, or in groups.
Look for: Certified Core Energetics therapist
Draws from principles of Bioenergetic Analysis, Gestalt Therapy, Taoism, and Buddhism. Practitioners seek to make clients aware of unconscious behavior patterns.
What to expect: Clients pay attention to moment-to-moment experience in the body. Practitioners may use touch to provide comfort or support posture so client can focus on inner experience.
Look for: Certified Hakomi therapist
Phoenix Rising Yoga Therapy
Based on Kripalu yoga, but compatible with all forms of Hatha yoga. Focuses on yoga’s transformative aspects rather than on physical alignment.
What to expect: Through assisted yoga postures, breath control, and dialogue techniques, practitioners allow the client to explore the sensory, emotional, spiritual, and historical information that the body holds. Body-scanning and meditation techniques may also be used.
Look for: Certified Phoenix Rising Yoga Therapy practitioner
Draws from techniques that emphasize movement, including neurodevelopmental therapy, dance therapy, and yoga. By increasing clients’ body awareness, practitioners help them take an active role in relieving tension, chronic pain, and emotional difficulties.
What to expect: One-on-one or in groups, practitioners guide clients through a combination of hands-on work, exercises, anatomy lessons, guided imagery, and dialogue. Sessions are tailored to individuals, and may use music and props like rubber balls to encourage movement.
Look for: Certified Body-Mind Centering practitioner or teacher
Clients coping with trauma seem to find body psychotherapy especially helpful.
Fifty-three-year-old Jeanne spent 20 years in talk therapy trying to overcome a profound depression rooted in a horrific memory. At 17, Jeanne saw her father and a boy from the neighborhood on fire after a grill exploded in her backyard. She was unable to save them.
Talk therapists gave Jeanne coping skills to deal with her stress, but she continued to have flashbacks symptomatic of post-traumatic stress disorder.
In her first Rubenfeld Synergy session, she returned to the scene of the tragedy by way of her senses. “[My synergist] asked me to turn my head to the left and say what came to mind,” she recalls. “When I did, I saw my father burning. When I turned my head to the right, I saw [the boy] burning. It surprised me how intense it was.”
The brain is incapable of integrating aspects of traumatic experience, explains Dr. Bessel van der Kolk, medical director of the Trauma Center in Boston and professor of psychiatry at Boston University School of Medicine. While talk therapy can help, it often isn’t sufficient to turn off the chronic state of alarm lingering in the nervous system. “The organism was traumatized, not the thoughts,” van der Kolk says. “You can’t talk your way out of it. When you work with the body, you can complete those actions that were frozen the moment the trauma occurred.”
Trauma, not surprisingly, is one of the areas where body psychotherapy can be controversial. Traditional therapists may question the qualifications of alternative practitioners, who may be unlicensed and lack advanced degrees, in dealing with such serious issues. And many fellow body psychotherapists concede that moving into body sensations too soon can retraumatize clients. It’s the clinician’s job, explains body psychotherapist Joel Ziff, Ed.D., to work with clients to determine when movement, touch, or simple body-awareness exercises are appropriate.
With her synergist, Jeanne worked through the trauma a little at a time. “She’d press on the sole of my foot or move an arm gently and ask me to notice what came to mind,” Jeanne recalls. “All I could ever see was the fire. I’d feel nauseous, but each time I went into it, I think I released some of the trauma from my body.”
Six months into her sessions, Jeanne had a revelatory moment. Returning to the scene of the accident, she saw something she’d never seen before—the backyard where the incident had happened. “I saw the swing set and trees, the rosebushes and a stone wall,” she recalls. “It was as if everything was in perspective. I wasn’t trapped in one image anymore.”
She says depression no longer dominates her life, and the fire’s terrifying images are no longer stuck in her body. “I’ll always startle at certain noises,” she says, “but the trauma feels mostly resolved for me. I’m no longer frozen in time and space.”