Positive Health Online

This month's column will be a special one, written by me and a friend and colleague who works in the related field of psychotherapy – Dr Sheldon Litt.

Dr Litt trained with the founder of Gestalt Therapy, Dr Fritz Perls, and is the author of Humanistic Psychology and Gestalt Therapy (in Swedish). He is in private practice and offers seminars.

This article discusses the crucial relationship between Dr Litt's work – the field of psychology – and mine – bodywork.

For the most part, these two related but distinct disciplines have not communicated with each other. Bodywork has to a certain extent grown from roots in physical therapy, chiropractic, etc., while psychotherapy originated in the heavy abstract theories of Sigmund Freud. Freudians as a rule neglect the body entirely – the patient lies on a sofa with his back to the analyst, who often has no idea what the patient's body looks like. There are patients suffering from anorexia who were in analysis many years without the analyst ever being conscious of the patient's body weight. Freud steered therapy away from the conscious here-and-now up to the fuzzy stratosphere of the unconscious.

Perhaps the first person to break with that tradition was the innovator Wilhelm Reich, one of Freud's disciples. It was Reich who brought the body into psychotherapy, pointing to the obvious interaction of the body and the mental processes. For Reich, "the body is the unconscious". Though shunned by orthodox Freudians for his heretical ideas, the influence of Reich has permeated certain schools of modern psychotherapy. Fritz Perls, the founder of Gestalt Therapy, and Dr Litt's teacher, built a powerful combination of Freud and Reich into his new highly effective therapeutic approach; Perls seasoned this with the sharp tenets of existentialism (take responsibility for your actions), and for structure adapted the perceptual organizing principles of the early Gestalt Psychologists (figure/ground, closure, etc).

Perhaps the clearest explanation of what Perls attempted to do was given by Paul Goodman, his collaborator on the major book (Gestalt Therapy, 1951, now in Penguin), who stated in one of his essays that the goal was to institute a "yoga for the west" – ie body awareness and integration of mind/body without the eastern mystical philosophizing.

Of course, after Perls, there have been many other attempts at utilizing the body for psychotherapeutic gains – the bioenergetics of Alexander Lowen, various movement therapies, dance therapy . . . and many new approaches too numerous to mention in this short article.

It was Reich who postulated that the person's hidden emotions are locked into the body in the force of muscular tension, etc – "body armor" he labelled it.

Reich's therapeutic system was based on attacking this armor in order to release the blocked energy. Then the patient would be freer of symptoms, and according to Reich, experience fuller orgasms.

Perls approached it from another perspective: guide the patient into realizing how he is holding back, how he tenses his muscles . . . so that with increased awareness, he can learn to release the tension himself.

For body workers, this means that you should be aware that effective work with patients often evokes strong emotional responses from the client as this locked-in energy is released. You, as a body worker, must be prepared to deal with these feelings, and also with your own sometimes unexpected reactions to your clients' powerful emotions.

On a more fundamental level, it would be very useful for body workers to undergo some psychotherapy training since increased knowledge of self will lead to a better understanding of others. We recommend that body workers take seminars and training courses dealing with the interaction between psychology and body work. Such courses should include the following topics:

Transference (positive and negative), counter-transference (ie your feelings for the patient), communication skills, "the difficult patient", recognizable signs of mental disturbance, dealing with strong emotional reactions by normal patients, etc. In addition, students should get a strong dose of personal development, learn how to use one's own feelings as a "tool" for helping others.

Fritz Perls himself had sessions with Ida Rolf and they also discussed the possibility of holding joint Rolfing-Gestalt therapy training sessions. Unfortunately, this super-training course was never realized, but it would have been a masterful experience indeed.