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Touch in Psychotherapy

Touch in psychotherapy has been a controversial topic. This is a very complex discussion as there are many considerations to balance.

First though, let’s discuss a basic misconception still prevalent within vast swaths of psychotherapists and medical professionals, as well as society at large, for that matter. Namely, the mind/body dichotomy and it is still alive and well within psychotherapy since Freud. Wilhelm Reich bridged the scientific and theoretical gap between mind and body elegantly. Reich, through years of clinical experience with patients, and a legacy of scientifically validated laboratory experiments, documented how patients’ psychic conditions were reflected in medical conditions and how physical conditions were mirrored in the psyche.

Is our body reflecting chronic pain, inflexibility, or ease? Is our energetic system available to us for creativity and personal contact, or are we struggling to have energy and feeling drained and uninspired? The body/mind has a unitary function. Yogi masters have understood that oneness, as have other Eastern martial arts experts and visionaries from other schools of thought. This knowledge base is advancing through accumulating research, for example: the effects of being raised by one or two parents on adult blood pressure and early attachment problems impacting development of leaky gut, to name just two among thousands of studies. Slowly but surely, professionals in medicine and psychology increasingly incorporate the basic paradigm that sometimes you cannot tease apart the mind from the body.

Reich created a systematic, psychotherapeutic method that directly impacts both ends of the spectrum: the psyche and the entire physical status including the nervous, muscular, circulatory, hormonal and immune systems, and other subtle inter-systemic relationships down to the genetic and cellular level. Our thoughts, emotions and reactions that create our ‘stress level’ (quantified by elevated hormonal levels in the body) are woven through all systems of the body via various hormonal and neurological messengers (structural, biochemical or electrical). So you can see how deep the mind/body relationship flows from top to bottom, bottom to top, inside to outside, from cell to psyche, from one system to another in one gigantic flow of communication.

Back to the topic at hand: touch in psychotherapy. As I stated, this is a complex topic and one not to be taken lightly. Psychotherapy has to be conducted within an established, structured frame that takes into consideration the client’s mental status, the problems at hand, and the unique character defenses of the client. Further, if biophysical work is included in treatment, it depends on the therapist’s comprehensive knowledge base and training – bodywork must be within a psychotherapist’s field of expertise. Licensed mental health professionals cannot ethically practice outside their scope of expertise. Said succinctly, unless you have been trained thoroughly in a mind/body approach, have an adequate knowledge base in physiology and medicine, and a thorough psychodynamic paradigm, working outside your area of expertise can be counter productive at the least and deleterious in many cases.

Touching a patient without thorough training can be invasive, contraindicated, and can fall outside important and strict therapeutic guidelines and frame that creates safety for the client and clear boundaries for the therapist. To touch outside the therapeutic frame is to create chaos, possibly inappropriate and confusing gratification, leading to a sticky relationship that undermines real therapy. You get my point. Only with training that exactly delineates the path will somatic interventions have the potential to be effective.

Orgonomy is one path that delineates the method, model and step-by-step protocol of treatment that ultimately includes hands-on interventions in the form of touch, pressure on various parts of the body, expressive exercises to help release various holding patterns, and work with the breath to facilitate healthier breathing patterns as well as biophysical and emotional release. Techniques that directly intervene in the body’s templates allow clients to connect their dysfunctional personality components that have contributed to chronic physical aliments. As the various blockages unlock, feelings are expressed deeply and the body-mind feels more ease, balance in the autonomic nervous system, and, therefore, greater general health is possible over time.

The importance of touch is an extensive conversation so I will give you a sense of what I am getting at without too many details. Bottom line, we need and crave touch as it is a basic and essential aspect of human survival. From the moments we float in-utero and are born, we need sensitive physical contact that envelops us. So much is communicated and felt through wordless touch. And with it, the organism feels safety, support and trust throughout his whole organism. We call our earliest connections with our caretakers, attachment development. And how we attach comes in various shapes and sizes, some trusting, others not, and attachment styles effect us throughout our lives. Our attachment needs continue into adulthood and, by the way, a trusting relationship can help heal early ruptures in attachment. One way attachment is experienced and expressed is physically. In fact, in the physicality of a couple or family, the wordless reassurance of tender physical contact reinforces repeatedly, or not, the chemistry of security and connectedness. Simple, ample affection, – a hand on an arm, fingers linked, cuddling, etc. says “we are together, I am with you, you can let go, relax, bathe in the elixir of knowing that I care for you”.

Our autonomic nervous system, often in fight or flight, tries to maintain our survival in a demanding world. That constant struggling leads to difficulty shifting to appropriate relaxation responses. I have written about this in prior posts (read Rest & Relax here). From our rigid survival stance, with all our defenses up, we don’t soften easily. We use alcohol, food or other drugs to access a way to come down. Sometimes these cravings are compensations for unconscious longings for soothing that we are unable to give to our selves, or give to or get from others. We learn to be self-sufficient and walled off, until we no longer consciously need or can no longer give. We won’t permit attachment to others when we are walled off.

The Orgonomic model of therapy has a progression. First, the therapeutic relationship is established, defenses illuminated, and acting out behaviors contained (raging, substance use, binging, cutting, anorexia, workaholic behavior, dominating others, hyperactivity, sexual addiction, obsessive-compulsive binding of anxiety, are some examples). The client’s inherent negativity has to be culled out, understood and worked through sufficiently. Then the client can approach deeper feeling states because the defenses and acting out behaviors are dismantled sufficiently, allowing memories and trauma to rise to the surface. During the earlier stages, when the client is ready and willing, the Orgonomist works simultaneously with talk therapy and on the couch dissolving hardened armoring in various segments of the body (see multiple posts on the segments listed on our blog page here). Those interventions are challenging and can be painful, as the muscular holding is stubborn in many areas: jaw, neck, shoulders, thoracic, thighs, calves, for example. Intense, concentrated pressure is involved to break muscular holding down and free the feeling and expression held within.

Later in the progression of treatment, as the outer layers of biophysical and character armoring are dissolved, and hard won insights accomplished, the client and therapist can communicate together with an even deeper underbelly of feeling, memory and experience – right brain to right brain. These emotions and expressions are softer and deeper, and longings can emerge as well as the crushing sorrow/loss/abandonment depression. These client experiences within the bodywork context are at times like altered states, although the client is in contact. There can be strong sounds and intense emotions, as the body expresses what it could never feel, much less express. These are hard times for the patient but also very relieving.

Fortunately, in Orgonomy, we are trained to touch the patient and provide an experience of soothing that helps ameliorate the pain a bit. We can provide essential drops of nurturance that were never before experienced on a visceral level. It is a nuanced touch that does not overwhelm but rather approaches a basic need. From that inference, the client can realize what was missing and the body responds to what is given. That type of therapeutic touch does not remove the pain artificially or with an illusion that is inappropriate. Rather the contact is sincere and the client stays in her own skin to absorb and heal.

This healing touch at the right moment can do wonders for the process and it resides in the viscera, not in the head.

In our lives and our relationships, realize that contactful and sincere touch makes significant difference to achieving health in our lives. Our attachment needs are critical throughout our entire life. If we are deprived of touch and warmth from friends, family and community, we will suffer greatly. Bottom line: remember to make physical contact when you can, with connection that is warm, open and sincere.

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