Acknowledgements
“Have you ever received gifts? “I was asked by one of the neuro-linguistic programming specialists. Apparently, he wanted to “anchor” my state in my process of recollecting the pleasant experiences corresponding to receiving gifts, and then use it for some purpose which was unknown to me. I do not know if that specialist achieved his goals, most likely not, but I am grateful to him. When I conscientiously turned to my experience, I was horrified to find out that I could not remember a single occasion when I received gifts, until I suddenly realized that the main gift is life itself. All the others are simply lost in comparison with it.
Who made this gift for me? I do not know. But I know that my parents, who managed to survive difficult times, are a big part of it. I am grateful to them for their viability and for caring for me. This applies to all my relatives. My positive thinking, or even more broadly, my positive attitude to life is owing to my mother Elena Sergeyevna, who was also my first school teacher, and all my other teachers, among whom I remember with special warmth Galina Alekseyevna Kolobina, Valentina Konstantinovna Tarasova, my History teacher Mikhail Ivanovich Chekalin; my Philosophy teacher at Medical University lion Semyonovich Chernyak, Professor of Psychotherapy Mark Evgenievitch Burno, my internship tutor Vladimir Elizarovich Smirnov, whose clinical thinking is still a model for me; my associates Vyacheslav Nikolaevich Tsapkin and Vera Kerpelevna Loseva, who helped me, a doctor by training, to get closer to the psychological vision of a person; my friend, a “symbolic primitivist’ artist, Vladimir Boldyrev, whose creativity prompted me a number of ideas; all my patients, without the cooperation of whom this book would not appear.
I thank all my colleagues. I especially would like to mention Igor Kanifolsky (St. Petersburg), Alexander F. Bondarenko (Kiev), and Steven Shoen (USA). The experience of their work and behavior were significant for me. Thank you to everyone I have ever met.
Andrey Ermoshin
To the english-speaking readers
«Things in The Body» is the first of a series of books that describe Psychocatalysis. It has been published in several editions in Russian and has already become a kind of classic for a whole generation of specialists. An increasing number of psychotherapists are adopting the ideas of this book: to organize the reverse development of symptoms associated with the experience of problems and injuries, to lead the patients to calmness and regeneration of their state without re-traumatization and without provoking catharsis.
In most of the cases catharsis is not only useless, but also harmful. It gives just temporary relief. It does not solve the basic problems of a person, but, on the contrary, it aggravates them. Nowadays many specialists come to understanding of this fact, whereas, when the first edition of this book was published about 20 years ago, it was not so obvious.
To psychologists and even some naive doctors, the psychodynamic approach, with its working through resistance and unleashing the repressed reactions of the body, seemed attractive, although it is only an imitation of psychotherapy.
Such seduction by seemingly effective work led to many secondary problems of the patients: loss of time, effort, and resources. For some patients and clients that was fatal. They committed suicide or, having passed into the category of psychiatric patients, had miserable life under neuroleptics.
Psychocatalysis, as an alternative approach to working with neurotic patients, goes back to the traditions of the inner practices of Orthodox monasticism and, in part, to the healing traditions of Russian people. It is in this tradition that the hysterization of a patient is not welcome. What is practiced is the «shrinkage of passions’ and «laying off’ the perceived provocations on them, «letting go of fears.»
I hope that the English-speaking readers, whatever culture they belong to, will be interested in correlating their approach with this «Russian’ approach.
Other books on Psychocatalysis: «Phobias, Disappointments and Grief: A Fast Remedy», «Learn Languages Easily: Methods of Self-Regulation for Successful Learning» are also available in English. Other books: «Geometry of Experiences» and «Enigmatic Syndrome: Panic Attacks and Their Treatment" are in the translation process.
I will be glad to get your feedback: erm@list.ru.
Have pleasant and useful reading!
Author’s preface
My given body — what to do with it?
It’s so mine and so fit.
Josip Mandelstam
Two patients are talking in a surgical ward in the presence of a third person who has just regained consciousness after an operation: «Our surgeon often leaves things in the bodies of his patients. «He left a glove inside me,» says the first one. «…and I had his hat,» says the second. The newly operated patient looks at them with concern. At that very moment, the surgeon comes in and asks: «Has anyone seen my coat?»
Things in the body… First of all, I would like you to note that we are not talking about things forgotten by the surgeons in the bodies of their patients, but about the objects in the ’body’ of consciousness left there by the people themselves. They are not tampons or scalpels, but anger and resentment, disappointment and sorrow, jealousy and anxiety. Though these ’objects’ cannot be seen with X-rays, their effect on our health is disastrous.
Fuel
We usually speak about feelings, emotional charges, or affections (as psychiatrists call strong feelings, which arise in extreme situations) not as items, but rather as something fluid and striving for expression. Love leads to hugs, disgust — to repel, anger — to kill, and compassion — to heal the wounds of a neighbor. An emotional charge is sort of “fuel’ that drives a particular action.
Is that what nature conceived? When the «action’ is done, a feeling of satisfaction comes. All would be well, if not for situations in which emotions do not find their natural way out.
A person is burned
What happens to a charge when it cannot be released? Such emotions can be left “burning’ for many years if there is no way to send them to their “addressee’ or “to cancel them’. Then a person burns. In some cases, those emotions “burn out’, leaving behind an unpleasant “sediment’.
The «fuel’, which was originally light, thickens to the consistency of gas, gas — to the consistency of liquid, then liquid — to mass, and mass — to stone. Finally, we get a «petrified emotion’. Sometimes the human soul is left holding these «stones’ of mental anguish. As the cause of these emotional charges originate from the outside, we can think of these «stones’ as «foreign objects’, which are difficult to experience, understand, and to convert.
The situations that trigger strong feelings are different, however, both petrified emotions of «our own production’ and these «stones’ or «foreign objects’ that have been taken into the soul from the outside, are capable of disturbing the human condition…
A heavy stone pulls to the bottom
The basic form of loss associated with the carrying of “stones in the bosom’ is a distraction from perception and activity. The feeling of resentment in the chest “depresses’ the hands, the feeling of fear in the stomach influences the legs and all other parts of the body. Attention is taken not only from the parts of the body, but also from the parts of life. A person is “wrapped’.
Collected negative charges are not only stealing a person’s potential. They also distort it, and therefore increase the risk in a person’s life. This risk affects almost all areas: health, family, work.
Talking about health, such a risk, under certain circumstances, comes out in the form of psychosomatic diseases. The most common of them are gastric ulcers and duodenal ulcers, hypertension, bronchial asthma. The whole list occupies a lot of pages in medical manuals.
In the sphere of interpersonal relations, the harm caused by untreated lumps of resentment in the chest, or balls of irritation in the temples, or the fog of anxiety in the forehead, etc., is well known to everyone. They lead to those «twists’ in our relationships that make life so difficult. The destinies of entire generations, peoples, not just individuals and families, are collapsing. There are more than enough such examples in human history.
Creative activity also suffers from the emotions which do not find their outcome. A person does not fully use their potential and unprocessed charges spoil the results. Not to mention the fact that a one-time failure in psychic functioning can cost a person their life. A heart attack, a fight, a fatal mistake at work — the risk can manifest in thousands of different ways, and it «knows how to wait’. I do not think we should let it just happen.
Something must be done
Everyone intuitively understands this. We rely on our self-regulation: the body seeks to solve problems while asleep, or in the process of life itself. However, when in stress, self-regulation fails, and time is not a cure.
In such situations some people use alcohol or drugs, but they cannot solve the soul’s problems. In cases of failure of the body’s self-regulation, many people turn to a psychotherapist. At the same time, patients often ask the question: how do you expect to help me?
Something new
It is not about medicine, hypnosis, or psychoanalysis. Though, all of them can be used. We are going to talk about working through sensations.
This is an amazing kind of work when such expressions as «lump of resentment in the chest’, «a fog of anxiety in the forehead’, «a steel plate of control in the back of the head’, «a jellyfish of fear in the stomach’, and «a dagger of betrayal in the back’… sound like a diagnosis. «Cupid’s arrows in the heart’ seldom become a reason for complaining. People more often consider them a sign of happiness, though, not always knowing what it really means.
You do not have to be in delirium tremens
Maybe to find such “things’ inside one’s own body a person needs some special conditions? For example, is it necessary to be poisoned with ethyl alcohol to the state of delirium tremens? The doctor holds out an empty hand to the patient and asks:
«What is in my hand?»
«A wire.»
«What will you do with it?»
The patient starts to wrap it around his arm.
Is anything else needed to help people to realize what they are «carrying’ inside their bodies? Not at all! Moreover, it is not about the understanding of what is absent, but only of what is really present.
A person, encouraged by a few questions, is able to describe the «content’ of their inner space. However, they are invited to advance in this a little further than they usually do.
How many cats are there?
Very often people describe their anxiety as “cats are scratching my heart’, “my tower is bursting’, etc. In such cases a psychiatrist begins to think about the medicine for a patient and a psychologist studies the conflict in the relationship that gave rise to such a state, but it is very unlikely that the patient will be asked the clarifying questions: “How many cats? Color? Size? Did they start to tear your heart at the same time or one after another? Are the walls of the tower thick or thin? Is there anything gaseous or liquid in it? Is it like a mass or like a solid body? Anything else?”
Therapy based on sensations opens an amazing opportunity through such questions to go to the energy charge associated with the experience.
The mouth of a shepherd
I was in my early twenties when I was attacked by a male shepherd dog. In the moment, when I saw its open mouth, I automatically put my hand in and grabbed its tongue following my father’s advice. So instead of closing its jaws, it tried to unclench them as much as possible. However, I did not know what to do next. The idea is to swing the dog away. Unfortunately, I realized this later, and had to wait for the owner to arrive. When I let the dog go, it bit my forearm. I still have scars from its teeth.
Why am I telling you this? Well, somatotherapy is something like inserting your hand into the mouth of a shepherd: a movement by the shortest path, then an open confrontation with the agent upsetting the consciousness, «grasping the tongue’… As we see, the most important thing is to understand what to do next.
Three types of psychotherapy
According to the tradition started by Freud, most types of psychotherapy seek to bring out what is “hidden’ or “pushed back’. They consider dreams, free associations, and other manifestations of human mental activity, often similar to a complicated cipher. With the help of a secret code, which is known to a highly experienced psychotherapist, it is possible to open the deep mental movements of the patient during their collision and resolve the conflict.
This applies to the so-called psychodynamic tradition in psychotherapy, working with the content of symptoms in the in the collision of the soul’s motives. Since this approach considers the meaning of symptoms, it can be called psychosemantic.
The so-called clinical psychotherapy is not so interested in the meaning of symptoms, but very closely examines the basis on which they have grown. This psychotherapeutic tradition is addressed primarily to the human constitutional (body structure) and genetic type of the patient and helps a person with the specific traits of personality to find their place among other people. Clinical psychotherapy found its vivid expression in the works of Ernst Kretschmer, who, in my opinion, is a figure, at least equal to Freud.
We can also talk about another way of psychotherapy. In contrast to the psychodynamic and clinical areas, here the main interest is focused on the external elements (in relation to the basic constitutional and genetic personality type) — on how specifically the experience is expressed, and, in particular, on how much energy the body spends on its «feeding’. This approach can be called psychoenergetic, to which somatopsychotherapy belongs.
I’m not interested in “what’ and “how’ — I’m interested in’ how much’
In a simplified form, the position of a somatopsychotherapist can be stated as the following: “I am not interested in what the patients thinks or how they do it, I am interested in how much they think about it, how much energy they give it. If it is more than the “normal’ it is a disease, if it is less than “normal’ it is also the disease.
If, after a trip to England, they think they ate beef infected with «mad cow disease’ (BSE), I am not going to talk to them about the incubation period of variant CJD. I am also not going to dissuade this person that they caught a terrible disease and now they are going to die. (Especially since I do not know if they are infected or not.) I am interested only in one thing: how long are they going to think about it? Now they dedicate to this almost 24 hours a day, spending 99% of their vitality. Is that what it needs, or can it be less?
How can I make a person who has lost sleep and peace think about the amount of energy spent on the experience (and not on solving problems)? Here is the answer: through simple questions about what they experience «at body level’ because of what has happened.
The soul has a body
As it turned out, two simple questions “Where? ‘and “What ‘set in relation to experiences, lead to the fact that… the soul reveals its body! The feelings are “depicted’, and the soul, just as light, reveals its particle nature along with the wave.
The name of the method — ’somatopsychotherapy’ — emphasizes its specific feature. It works with the soul as with the body (or with the body as with the soul). However, this body is not physical, «medical’, but the body of consciousness, the «psychological’ one.
Somatopsychotherapy (SPT) (with the emphasis on the first syllable, from the Greek «Somos’ — «body’) — SPT-stands for: «Work with somatized equivalents of mental experiences. Fortunately, this formulation intrigued not only my children, who used to ask asked me: «How are your «somatized equivalents’ doing there?» My colleagues’ interest in my work encouraged me to think about writing the book that you are holding in your hands now.
“Filling’ of the body of consciousness
As a result of the catalysis of bodily sensations, the consciousness-body shows itself as “filled’ or, rather, realized as a set of “mental objects’. They can be “good’, such as love, joy, etc., or “bad’, such as hatred, fear, etc.
If we consider a person in this paradigm, it turns out that by the time of the meeting with the therapist, they (as a result of the elections, consciously or unconsciously made by the body earlier) have transformed into light, warmth, space, lightness — and then there is no need for a therapist, or on the contrary — into the darkness, heat, tightness, heaviness in places of linkage or accumulation of energy (substance «heat — heaviness’, as it is called in SPT), and at the same time — into dullness, cold, «aridity’, numbness in the devastated areas. In this case we have all the indications for therapy.
The “backward’ therapy
The therapy based on body sensations moves in the opposite direction to what has been developed in most modern psychotherapeutic approaches. I call them “therapy forward,” which is aimed at the release of a once pent-up emotional charge. Through the study of resistance, the dynamics of expression is encouraged. The opposite “dynamics of the suppression’ has also got some supporters. What, if not suppression, is therapy by “coding’ or “torpedo’ in case of alcoholism?
True and false alternatives
During exams in medical school, students are often asked a provocative question: are lobar pneumonia-rale in the lungs fine or large bubbled? The correct answer does not imply either the first or the second options, because there is no rale in the lungs in case of lobar pneumonia.
So, to encourage expression or suppression of emotions seems to me the same false alternative. There is at least one other way out — to return to the original situation… through the entrance. Emotional life is not a one-way street where traffic jams occur. It resembles rather a flat surface with a ball on it, which can lurch in any direction. The ball can roll back just as it can move forward until it falls from the surface. Instead of building barriers to the movement of the ball, you can change the angle of inclination… it is possible to simply calm down, refusing both expression and suppression of emotions. It is not the same as giving emotions a way out. That means getting them back in.
Perhaps a comparison to removing the detonator from the bomb would help to explain what I mean. The disposal of an explosive projectile would mean refusing both to detonate it and to conceal it. When it is dismantled, it is possible to think of the new use of the potential energy stored in it. The same uranium that threatened to destroy all life can become a filling for the reactor of a power plant, supplying both light and heat.
Thus, we can give forces the ability to stop completely, go back, and then look for a new solution to the problem, being in the new state. This is the way to discharge both dynamics.
The psychostatic paradigm
Stopping consciousness and turning it into a body is a method, that opens up new opportunities in psychotherapy. I have called it psychostatic, after correlating with better known psychodynamic principle.
The above-mentioned principle «where’ involves searching in space for the affects as charged objectified (somatized) structures and allows us to speak about «topographic (or topical) psychology’ (perpendicular to «chronological’ — in particular, transpersonal). In general, this method can be called «Topographic psychology and the psychostatic paradigm in psychotherapy.»
Therapy «backwards’, is the technique of «zeroing the patient’s condition’, calm «without annexation and indemnity’ — these are some of the names of the therapeutic part of the work.
This method is a worthy alternative to the existing methods of restoring the psychophysical balance of a person.
An eye view can melt the stones
Instead of trying to revive the almost dead (“petrified’) feelings, somatopsychotherapy offers to “dissolve’ them, to let them “die’ completely. Though, not to disappear, but to be reborn in a new capacity.
One of the discoveries of somatopsychotherapy, in my opinion, is the fact that, if a person refrains from hysterical, hypochondriac, phobic and other pathological ways of responding to the fact of the awareness of the «stones’ within them, and retains a calm, judicious attitude to conscious, this suffering person becomes a winner, they get their power back, reborn like a Phoenix from the ashes. The task of the somatopsychotherapist is to help the patient create and maintain a working tone in relation to these phenomena, without unnecessary affectation, but by understanding the significance of what is happening.
The patients can melt the stones with their own eyes, and it will not be just a «game of imagination’, but a real change to: 1) the structure of their consciousness; 2) the state of their body.
Working with sensations as a method of psychotherapy is highly effective and fast-acting. It can change the patient’s condition radically and do it without the phantasmagoric external manifestations inherent in some known types of therapy.
For my last preliminary remark, my own experience and communication with colleagues brings me to the idea that along with the division into schools in the world practice, there is a very simple division into «fast’ and «slow’ or «short’ and «long’ types of psychotherapy.
Experience makes us accept the fact that all forms of work are important. The fact that you can work with a patient for five, ten minutes, or even a year, or two, or more, and all this will be normal psychotherapy, does not seem to be a paradox.
So-called classical schools, such as clinical psychotherapy or psychoanalysis, or younger schools like gestalt therapy, tend to work over the long time. Among «short-term’ schools, there are representatives of neuro-linguistic programming, next to them, perhaps, eriksonians and some other supporters of empirical, short-term, intensive psychotherapy.
This method also draws from the intensive and short-term schools. It is good for working through traumas. However, it is as thorough as the therapies of the first «classic’ group.
1500 patients
From my point of view, this study takes into consideration the most important issues of psychotherapy.
How to bring the patients to an understanding of their inner state?
How to change that inner state for better?
How to get a sustainable result?
After 15 years of research, this method has been formed by the process of solving psychological and psychosomatic problems of more than 1500 people during 3—5 sessions of one hour with each of them.
Introduction
Every psychotherapist and practicing psychologist know about patients’ descriptions of their bodily sensations. There is no more or less noticeable experience that would not be accompanied by a burning of the chest, or a pain in the head, or compression in the abdomen.
Different attitude to the body sensations
In classical medicine, the body sensations are taken into account to clarify the diagnosis and monitor the dynamics.
Clinical psychotherapy calls them vegetative accompaniments of experiences.
In psychoanalysis, they serve as a material for the interpretation and construction of structures, where through somatic symptoms «the body reports the dominant idea of the «subconscious’. The subject of the searches is the idea underlying the formation of the symptom.
In the context of Jungian’s approach, there can also be situations in which patients indicate body sensations in the process of experiencing certain archetypal scenes, but these feelings rarely fall into the focus of attention. More importance is given to the semantic elaboration of the symbols.
Gestalt therapy pays more attention to body sensations to establish contact with them, to find out their «addressee’, if any, and to complete the unfinished deal associated with them.
Psychosynthesis does not exclude the use of body parts to establish mutually beneficial contact between them. In this case heart, brain, stomach, ears, personified as subpersonalities, can sort out their relationship, but this process does not have the nature of direct work with sensations.
Reichian body-oriented psychotherapy attaches great importance to the analysis of the «rings’ of tension at the level of the eyes, mouth, neck, chest, abdomen, pelvis, forming a «protective shell’ around the body, delaying the free flow of «bioenergy’, and considers its important task to work through the «muscle armor’. However, this approach works primarily with the surface of the body.
Erickson hypnotherapists use descriptions of body sensations to create a background of reliability in the process of «soft trance guidance’. Bodily sensations in this tradition are highly valued for their credibility. With their help, hypnotherapists often receive from their clients, a credit of trust, which a person is inclined to give to someone who has correctly described at least three components of his bodily experiences. An erickson hypnotist describes what a person feels with their body but… thinks about something else.
Here’s how body sensations are characterized from the point of view of neuro-linguistic programming: «Evaluative meta-feelings about other perceptions or representations, also called emotions, feelings, or visceral kinesthetic, which are presented in the chest and/or abdomen, or in the midline of the body. These feelings are not direct sensations/perceptions, but representations derived from other sensations/perceptions." «Other sensations/perceptions» — specifically visual, auditory and kinesthetic — are the main focus of attention in NLP.
The ontopsychology of Menegetti attaches great importance to the knowledge of the doctor’s own body sensations in the process of communication with the patient and the study of «semantic field’. However, in this case the appeal to the sensations is of an official nature.
The process-oriented psychotherapy of A. Mindell touches the sensations in the prosses of working with the «channels of perception’.
There are many reports of body sensations during sessions of holotropic breathing according to the methodology of S. Grof.
We can say that every serious school of psychotherapy somehow reacts to the fact of the presence of body sensations brought about from experiences, but almost none of the existing schools work directly with them, thus remaining within the indirect use of this phenomenon. I would like to name the way it is done as external.
Psychocatalysis of body sensations works with sensations directly, «internally’ using them.
Traditional Russian attitude to body sensations
As real force that significantly affects the health of our fellow citizens, this tradition does not exist. The interests of the social experiment, which our country went through, demanded special personal qualities from its participants. The inclination to introspection was not listed among them. Moreover, its manifestations were considered almost counter-revolutionary. “The battles for the harvest’ and other “battles’ for agriculture, industry and other fronts did not include any study of body sensations. That era put forward its heroes. However, their valor was not intended to be healthy for, but rather, to be useful to society.
One of my colleagues told me a story about a group of American feminists who arrived in Moscow during the perestroika period. Instead of giving a long explanation, I will just say that she invited them to a public bathhouse… When the feminists saw the women around them, they began to cry. They could vividly imagine how those Russian women must have mistreated themselves to end up with such deformed bodies. The Americans ladies were particularly shocked by the extent of their distorted joints.
I would like to mention something about the souls of the long-suffering Russian women! Indeed, no matter what, they are distinguished by their commitment to compassion and sacrifice. It would have been necessary to have a remarkable strength of character to withstand everything that our parents and grandparents had to endure. Though, it would have been prudent to add a culture of personal care and self-preservation to such character and experience of suffering; a culture of working through the consequences of the resentment experienced.
I hope that my scientific work will contribute to the formation of such culture.
Domestic “tradition’
This is an example of attitude to oneself, and to the signals of the body, at the household level. Fortunately, this does not mean that in “the domestic’ tradition there is no other attitude to the perceived.
The Orthodox Church, especially the Byzantine monastic tradition of Hesychasm (sacred silence), which was developed in the environment of Russian monasticism, offered to be very attentive to what was formed in the mind of a believer.
I was greatly impressed by the topographic structure of the descriptions of «mind preservation’ by the Christian ascetics. Long before the emergence of any psychotherapy, they described the phases of entering into a passionate state and their ways out of dead-end experiences. Those experiences often resembled plants and animals.
We know such expressions as «seeds’ or «roots’ of passion. In the V century the monk Neil of Sinai wrote about «the foxes that live in the soul of the vindictive, and the animals that hide in the indignant heart’ or «as the water is perturbed by a falling stone, so the heart of a man by a bad word.» «As the smoke from smoldering straw bothers the eyes, so the rancor bothers the mind during the prayer’. These descriptions are more than just beautiful literary images, they are documentary evidence of the experience of internal work.
The image of perception of the soul and passion is found in the following excerpt by the monk Hesychius: «Distinctive in the old Testament, the high priest decoration (a pure gold plate on the chest, with the inscription: «Holiness to the Lord’, — ex. 28, 36) has a conversion of heart purity which inspires us «to heed the plate of our heart, so that, if it is black from sin, (if we can find it) we should hurry to clean it with our tears, repentance and prayer.»
«From incessant prayer the air in our minds is pure of dark clouds and winds of evil spirits." The concepts of purity or blackening of the soul, the quality of the «mental air’ in us are important for us and will be repeatedly mentioned in the book.
Sinful thoughts «come to the door of the heart and, finding it is not protected by mind, one after the other comes in, each in its own time. When one of these […] thoughts, rising to the heart, enters it, then brings with it a whole swarm of impure thoughts and, thus darkens the mind and heart, irritates the body and attracts it to the shameful deeds." The «Swarm of impure thoughts’ is not just a comparison, it is a documentary description of what is happening.
“Objectification’ of sensations in psychotherapy
To continue the conversation about schools, dealing with sensations, the method of bioenergotherapy (BEST), developed by E. I. Zuyev (St. Petersburg) should be mentioned first. BEST, as no other manner of work, enables a person to transfer to the practitioner (the operator) the nuances of body sensations. The peculiarity of BEST is that in the process of massage, which is more than just the mechanical interaction between the practitioner and the patients (which, rather, should be called work on the movement of sensations in the body) the latter are asked “strange’ questions: about the consistency of movement in the body “sensations’, the color of the inner space and other characteristics of the “body scheme’. The patient, for example, reports that their head is filled during the manipulation. “With what?” — the operator asks. The patient: “Air (water, milk, resin, lead, etc.)”. The practitioner holds the shoulder blade and asks again: “What am I holding?” The response is: “A chicken”.
Zuyev’s followers gently call the evocation of those felt images to be the product of «illusions’, the «suggestive effect’. They use this curious feedback to adjust their operational efforts, as well as to divert the patient’s attention towards the process of performing manual therapy procedures. Representatives of the BEST school also suggest: «The immersion in figurative reality is an integral part of deep diagnosis, since the patient «gives’ those images that are embedded in the structures of the subconscious. The creative application of the knowledge of psychoanalysis has limitless possibilities here.»
We can say that the psychocatalysis of body sensations is the development of BEST ideas in the direction of the psychotherapeutic usage of the ability of man to recognize the «schemes’ of a body.
Spontaneous detection of sensations
“A stone in soul’ is one of those images most often experienced by patients, but it’s not the only one. “Jellyfish’ or “octopuses’ of fear, sitting in the stomach and launching their “tentacles’ in all parts of the body. “Clouds’ of anxiety in the chest, forcing the patients to wring their hands and run around the room. A “mass’ of anxiety, bursting in the forehead, preventing them from sleeping. “Lumps’ of grievances in the chest, preventing them from breathing. “Balls of despair in the throat, squeezing tears from the eyes (“globus hystericus” in Latin). “Brain-eating snakes’ of doubt in the head and “steel plates’ of situation control in the back of the head, raising blood pressure to pre-stroke levels. “Lead shoulder straps’ of responsibility hanging on the shoulders, flattening the spine. Patients often describe their sensations in these terms.
The objectification of feelings in artistic speech
In everyday and poetic language and in proverbs, one can meet such expressions as: “my problems swell my head’, or “cats scratch my heart’. Joy is usually described as big, and grief as heavy. Doctors speak about the “neurasthenic helmet’, though it is not known how to get rid of it.
It is possible to give a lot of quotes from popular songs, for example:
«Don’t go to him, don’t go, he’s got a granite stone in his chest.»
Here is an example from a novel: «A young woman is standing in a dark and cold hallway, near a tepid stove, warming her hands, waiting to be called for dinner- and, having pursed her dried up lips, thinking… about what? About Rodion? It is all nonsense, that she has poisoned him, nonsense! But what if she really has poisoned him… my God! What must she feel? What tombstone is lying on her secretive soul!»
There is no need to add to the list of excerpts because the reader will be able to recall such collocations, used to describe sensations in the body during the experience of various emotional states.
Snakes in the head is not a sign of schizophrenia
Being a student of the clinical school, I used to perceive the evidence of patients about their feelings as a part of the information needed to help establish the diagnosis and verify the effectiveness of the treatment. If patients told me about the “daggers in their backs’, “the devil on their shoulders’, “worms in their heads’, I thought about senesthopathy, and schizophrenia.
Today, while working through «a given’ energy structure rather than an innate genetic one, I often met the descriptions of «strange’ feelings experienced by my patients. For me, the style of such descriptions is important. It can be epileptoid-photographic, cycloid-colorful, or schizoid-abstruse, or organically flattened. Knowledge of the patient’s character remains essential, but no less important is the fact that there is practically nobody who is unable to describe what is felt. The body experience, (or «experiences of the body’) is a phenomenon which is quite natural to people of any constitutional and genetic type and culture.
Bodily experience, conscious or unconscious, is constantly presented in the normal human sensory system. The only real «strangeness’ of descriptions of body sensations in the somatopsychotherapeutic process, is that they are made in the form of describing objects, which was not done before. It will be discussed below.
Sometimes patients can be surprised by the nature of their perception when referring to their feelings. They even ask in embarrassment: «Do you have a lot of crazy people like me?» The perception of what is felt in images is not a sign of mental illness. On the contrary, the ability to perceive indicates mental health. If we talk about diseases, it turns out that «snakes in the head’ are more a sign of pre-stroke than schizophrenia.
During the observation of the object descriptions of experiences it was found that the results of self-examination of the body sensations can serve, firstly, to activate the processes of natural self-regulation in the body (through the inclusion of the feedback mechanism) and, secondly, to organize accelerated changes in the mental status of the patient through focusing on this process.
An overview of the work with sensations
If we talk about the main issue of psychotherapy, it is, in my opinion, as follows: to get quickly to the mental charge which is «knocking down the patient’s energy circuit’ and decide on what to do with it.
There are a number of approaches to solving this issue, e.g. psychoanalysis with its method of free associations and catharsis while understanding the «primal scene’; gestalt therapy, which aims to modify the expression of feelings through finding a «formula’ of constructive appeal to the «addressee’, etc.
SPT implements a specific approach. In the diagnosis, it suggests turning to body sensations, finding unresolved experiences by their «mass’ (the technique of «objectification of sensations’), and in the therapy — calming down without preconditions, (the technique of «zeroing’). The special issue is obtaining new experiences.
Phases of work with sensations
Diagnostic phase
1. “Where?” (Sensations, associated with the experience — at the level of head, chest, abdomen?)
2. «What?» (Is it something big or small? Light or dark? Heavy or lightweight? The image of what is it?)
Evaluation phase
1. Can it be bigger or smaller?
2. What parts of the body are «de-energized’?
3. Did it emerge recently or long ago?
4. Under what circumstances?
5. Was it brought from the outside or formed inside?
6. What condition does it correspond to?
7. Does it solve problems or complicate them?
8. Do you want to continue living with this feeling or do you want to part with it?
9. What percentage of your forces is concentrated on it?
10. Would these forces be useful for anything else?
11. Other issues
Therapeutic phase
1. Calming down
2. Suspending
3. Testing of “secondary formations’
4. Application of the forces to new areas of activity
Psychocatalysis of body sensations
The essence of the work can be described as follows: the sensation in the body, corresponding to a certain experience, is objectified from questions about how much it “weighs’, what “volume’ takes, is it “light’ or dark’? After that, a decision about this sensation is made. It is either preserved, “fed’, applied to life in an unchanged or modified form, or, on the contrary, a person chooses to calm down and observes the resorption of this sensation.
After a short conversation, a patient is invited to turn to inner sensation and determine its nature. Where is there an accumulation of heat sensations or gravity? Where, on the contrary, is there a lack of filling?
When the location of the experience is revealed, there is a discussion about the evaluation of this formation which has been subjectively felt inside the body.
If the feeling has a negative impact on the health and way of life of the patient, the therapist invites them to take a decision on this formation or somatic structure. The correct outcome of this part of the work is considered to calm the patients. It is accompanied by the observation of the process of resorption or «shrinkage’ of the specific formation.
At the end of this process, the diagnostic phase is repeated. The key question of this phase is: «What is left in the place of the previous structure?» As a rule, it is defined as something scanty in size, volume, weight, something like a dot or a speck. Then it is specified once again: «Do you need it for something?» If it is not necessary, the patients observe the cleansing of the body from the rest of the experience that has spoiled their condition. Usually it is done by absorption, evaporation, washing out, etc. In some cases, «the dot’ simply «flies away’.
The result of this part of the work is the restoration of the balance of sensations in the body. A program of actions for the future is formed based on this state. A new style of behavior is developed for a problem situation to meet what caused a failure in the patients’ condition.
A series of sessions to «clean’ consciousness leads to a new level of freedom for the patients to use their mental powers and to changes in their way of life.
Diagnostic phase
Patients first come to the doctor, not always knowing what to start with. One thing is obvious to them: they feel bad. What is this «bad’ about? How great are the number of the ways to further communication between two people, one of whom is a doctor and the other the patient? This choice of paths depends a lot on the doctor’s viewpoint.
The therapist’s viewpoint
“I’ve slipped away from Aesculapius…”
Let’s consider what usually happens when a person turns to the “classic’ doctor. “What are you complaining about?” The complaints are recounted. Anamnestic data is collected. Then an objective examination is carried out: percussion, auscultation, palpation, followed by instrumental and laboratory studies. The sum of the data allows evaluation of the state of certain organs and to put forward diagnostic hypotheses. Differential diagnosis involves the selection of the most likely conclusions from the list of possibilities. In the future, the diagnosis will be refined using “ex juvantibus’, which is a process of making an inference about disease causation from an observed response of the disease to a treatment. The activity of the doctor at the same time is quite large. The patient is enjoined to be “obedient’, “to bravely endure all the hardships of service.”
Thus, the diagnostician in this relationship is a doctor. Their research tool is their «clinical apparatus’ together with devices that are extensions of their senses. Their direction of examination is the state of organs and systems. The position of the patients is to endure everything, as it is all about their functional status (patient is in Latin — «patient’).
Psychiatrists still maintain the impartial study of the psychopathological phenomena, the definition of symptoms, syndromes and «nosology class’ of the disease.
«Well-collected anamnesis is half the diagnosis» — these traditions are inherited by clinical psychotherapy. On one hand, allowing the participation of the patient’s personality in determining their fate, but, on the other, not overestimating the role of psychological factors in the formation of the patient’s condition. (Excessive psychologization is referred to as false psychology). Clinical psychotherapy is interested in the peculiarities of the constitutional and genetic type of a patient. A therapist plays the role of a mentor or a teacher: «a patient’s job is to be ill and a therapist’s job is to study their illness and to prescribe proper medical procedures’.
Healers without any medical training copy the expert in a parodical way. They know everything for their client, they will tell him everything: what was, what is, what will be, who «did’ it to him. Their main instrument is their intuition. They are ready to answer almost all questions, as well as cure all diseases…
There is a clear difference between the content of professional and non-professional approaches, but they do have one thing in common. They give the patient the role of a mute participant. (By the way, not all applicants for help reject such a passive role. Among the clients there are a lot of undisguised supporters of such a position.)
The directive position of the doctor in relation to the patient was especially present in the initial stages of the formation of psychotherapy. Charcot and his school, Pierre Jean, French doctors Lebo and Bernheim were the researchers of the phenomena of suggestion. August Forel from Switzerland did a lot in the study of somnambulism and the phenomena of hysteria, followed by the discovery of the origins of affective symptoms, particularly hysteria by Breuer and Freud. However, their methods also suggested a greater activity of the doctor.
Dialectical method
Laying the foundations of “psychological’ psychotherapy, Freud made a remarkable move towards greater interaction with the patient in the identification, interpretation and subsequent processing of their condition. However, there were “remnants’ of the old “hypnotic’ period of development of psychotherapy: the patient passively lay on the couch, the analyst was separated from them.
Jung was much more inclined to the ’dialectical method’. «If I, as a psychotherapist, feel an authority towards the patient and, in accordance with this, claim to know something about their personality and be able to make the right conclusions about it, then I, thereby, sign my own non-criticality, because I find myself untenable in assessing the person opposing me.»
Here is his description of the features of the «dialectical mode of action, i.e. the position avoiding any methods’:
«The therapist is no longer an active subject, but a witness of the individual development process. (…) The analyst here is not a superior, competent, judge and advisor, but a participant in the dialectical process as well as (now) the so-called patient. (…) In the relations «doctor-patient’, two mental systems are mutually correlated, and therefore any sufficiently deep penetration into the psychotherapeutic process will inevitably lead to the conclusion that due to the individual originality of the participants, the «doctor-patient’ attitude should be a dialectical process. (…) It is clear that more complex, spiritually higher standing natures cannot be helped with complacent advice, suggestions and attempts to appeal to a particular system. In such cases, the doctor is better to remove the armor of methods and theories and rely only on the fact that his personality is strong enough to serve the patient as a point of reference and support. At the same time, it is necessary to seriously weigh the probability that the patient’s personality may surpass the doctor in mind, spirituality, breadth and depth… in all such cases, the doctor should leave open the individual path of healing, and then the healing will not lead to a change in personality, but will coincide with the process of individuation, i.e. the patient will become who is in essence».
On the North American continent, Carl Rogers and other humanist psychologists have proclaimed confidence in the client’s own abilities for personal growth.
Significant development of this principle is in the NLP, offering to refrain from meaningful instructions and limited only to formal.
Following the client’s process is a fundamental principle of process-oriented psychology.
The risk of affirmations
Reflecting on the danger of affirmations, and even more on suggestion (in particular, in the process of psychoanalysis), V. T. Kondrashenko and D. I. Donskoy note: “There are certain difficulties in the use of suggestion. One of them is that the patient gets used to this regressive form of support and uses it as a prosthesis. The second difficulty arises if the suggestion is used without its subsequent realization. In this case, the suggestion of the analyst is not analyzed and, as a result, the patient may develop a new neurotic symptom complex. Most often this happens when the interpretation is presented to the patient as a dogma.”
Thus, suggestion, struggling with one complex, can give rise to another.
To sum up the above, there is a tendency to increasingly trust the capabilities of a person undergoing treatment in determining the process of psychotherapy. The principle of interaction, rather than impact, is becoming clear. A two-way process occurs when two people come in contact, although one is called a therapist and the other is a patient. There is a search for a solution to the problem when combining efforts. To achieve success, the therapist does not need to play a Superman, all knowing and able to do everything for the patient.
A person is a self-organizing system with sufficient resources. All they may need is some assistance in the use of those resources. This is the principle of psychocatalysis which is contrary to the principles of doing something for the patient, whether interpreting their condition or the selecting more useful areas of activity for them.
Somatopsychotherapy (I will try to show) implements this principle to the greatest extent possible. The instrument of «doing’ are questions. But before we talk about them, we will pay attention to some more general problems related to the self-training of a psychotherapist.
Pitfalls
“The clinic drives a psychotherapist,” said prominent Russian therapist S. Konstorum. "...The philosophy of human life… directs the life of the therapist and forms the spirit of their therapy,” K. G. Jung stated with him in unison.
What can prevent us from the realization of these truly golden principles? There are probably reasons for possible failures in their implementation, depending on the patient, but we will analyze what depends on the therapist. «Physician, heal yourself first» (the Church. — Slavic) is a long-known principle. Before you start healing others, follow the advice of the Delphic Oracle «get to know yourself.» (And change yourself — A.E.)
The merit of the introduction of the principle of preliminary and parallel analysis of the analyst themselves belongs to Jung. The need for this was also recognized by Freud.
A somatopsychotherapist, no less than the psychoanalyst or the Gestalt therapist, needs to study their own state, to know the tendencies of their reaction and the nature of their character.
Tendencies of character
In accordance with your personal character: mainly schizoid, cycloid or epileptoid — you may need to track tendencies for: complication, self-admiration, domination and for commanding.
The presence of asthenic traits in the nature of the therapist can lead to the development of the patient’s parasitic traits.
Neurotic complexes
It is obvious that the psychotherapists’ own traumatic experience and the presence of their unresolved life issues can complicate the process of psychotherapy. It is discussed in detail in different literature, and I will not dwell on this further.
Cultural stereotypes
Having accepted the fact that psychotherapy is not an area of self-affirmation for the power-loving, nor an area of self-gratification for the sweet-loving. It is also neither an area where excessively smart people feed their pride (nor an area of self-torture for a “good’ one), nor indeed, a sphere for solving neurotic problems of the psychotherapist, let us pay attention to the following:
Even if we assume that a «perfectly balanced’ person, who has undergone a long personal psychoanalysis or other thorough therapy, is engaged as a psychotherapy practitioner, that is to say, this person is pure in the sense of the absence of any tendencies to solve their own psychological problems when in contact with the patient; this «ideal’ psychotherapist still risks falling into «activism’.
It is difficult for a doctor to trust the «uneducated’ mind of a patient. They are used to being an expert, a specialist. They know the terminology to denote the patient’s different states. They are competent to prescribe and cancel medications, discharge the patient to work or leave home. They are responsible for the life of the patients almost more than the patients themselves.
For the psychologist it is not easier to tune in to a trusting attitude towards the client. Although initially, they are more «consultative’ and can imagine that, as a specialist, they must be «smarter, stronger, more agile’ than their ward.
For me, falling into all these «traps’ as a result of being interested in my self-development of the «purity of doing’, it became important to track my characterological response, my own neurotic problems and tendencies, which had appeared in the course of my previous professional life.
Below are some examples of my self-analysis (in the manner of «somato-analysis’). I also mention some of the experiences that I have gained through participation in a special program.
Remarkable school
For me it was a remarkable schooling to observe and then participate in the practice of addressing the problems associated with alcohol abuse (and complex problems) according to the methodology of Croatian psychiatrist Vladimir Hudolin. I got acquainted with this approach (called ecologic, family, systemic) in Italy, where I was invited thanks to the inter-confessional cooperation of the Russian Orthodox and Roman Catholic churches.
The so-called operators consider themselves to be a facilitator of the process of staying sober and sees their task as so much doing something for the families, but rather to create conditions in which the families themselves, having problems associated with alcohol consumption, can do what will save them.
If an «active’ approach is used, the alcohol addicted patient is usually «coded’, «torpedoed’, if not sent for the «compulsory treatment’ to the institution of a prison type. The new program of the environmental approach sometimes suggests leaving such a patient alone and start the treatment by changing someone in their family.
The essential point is the «return of responsibility’ («recuperare la responsabilita» in Italian) to the members of the club (the community of families) for the process they are going through. Practically this is achieved in the following way: meeting, «chronicle’, support to absent participants (patronage), the preparation of tea and other things are conducted by the members of the club at a time. The operator only cares about the safety of the atmosphere in which all this is done. Developing the pooling of experiences and resources of club members, they ensure that forces are not wasted on talking about politics, football, etc., thus restricting the simple rules of life in this community of self-and mutual aid: to just talking about the present and to rely on their own collective experiences.
In contrast to the common methods of «healing in one day’ (such as the above mentioned «coding’ or «torpedoing’), this environmental approach gives much slower results, but is incomparably more reliable. The result of the club meetings is directed to the future, to the life of the descendants of the club members. This result is not limited to a period of 12 months or 5 years.
In connection with my participation in that Italian program, I thought of a «plant’ agronomic metaphor. What will the gardener take care of while planting beets in his garden? About the soil and light of course, but he will not try to grow it himself instead of a beetroot. Likewise, it is especially important to the doctors to understand the limitations of their competence and not to overdo it. In the end, the patients are saved by their own effort, not only by the activity of the doctor. This is my conclusion.
Get some rest!
The doctor can see the problems in the form of objects, like a psychic, or guess their location from the “weak signals’ or detect them by testing or infer their presence in many other ways not unlike famous detectives. On the other hand, psychocatalysis specialists will refrain from the open use of their “brilliant abilities’ and their trained “clinical machine’. During work sessions with patients, they will leave their knowledge and intuition out of the equation, trusting the abilities of the mentee. By answering questions, the patient develops the ability to visualize and can even find a path to enlightenment. Questioning is of crucial importance to the process of somatopsychotherapy.
Of course, this does not negate the importance of the training of an «assistant’. Both clinical and psychological preparation is extremely important. Understanding the human character, the peculiarities of nosology classification, the dynamics of experience significantly accelerates the therapy: the ability to ask relevant questions is a great art. However, trust in the patient’s ability to respond in any case remains truly relevant.
One of the components of the internal training of the questioner, including the key to their ability to withstand the intonation, to provide the choice of an answer to a patient, is the understanding that the patients are able to determine their own feelings. This is one of the postulates of therapy through questions about body sensations.
The research tool
The technique of the «objectification of feelings’ falls under the category of indirect methods. This means that it «includes’ the initiative of the patient and activates his ability to determine and change his state. The solving of this problem is based on the amazing, but usually unused human ability to self-diagnose their own condition as specific images of objects.
This process is called psychocatalysis, by analogy to a catalytic chemical process: there is a «substance’ that can change its state — a petrified emotion — and there is a psychotherapeutic influence (the catalyst) without which this process is difficult, slow or stuck. When they are combined, a «miracle’ occurs.
The patient’s attention is the main active element but is expedited by the catalytic effect of psychotherapist’s questions.
There are two main questions in the diagnostic phase: WHERE and WHAT.
“Obstetricians’
Socrates, with his “skill of midwife’, more than 2000 years ago showed the effectiveness of asking in a philosophical conversation: “People, when being asked right questions, decide themselves what is necessary…». The discovery of the role of questions as “birth attendants’ is perhaps as significant in the field of interpersonal communication as the discovery of the wheel in technology.
The effectiveness of questioning, instead of stating, was noticed by many wonderful masters not only in philosophical circles but also by the medical «maieutic’. (The Socratic Method, also known as maieutic is a form of cooperative argumentative dialogue between individuals, based on asking and answering questions to stimulate critical thinking and to draw out ideas).
I mean not just ancient the Zen Buddhist teachers with their unanswerable questions («How does one-palm clap sound?»), or the Sufi sages, or Orthodox saints, who, by asking questions, revealed the «soul problems’ of their disciples, spiritual children, no worse than a surgeon with a scalpel reveals ulcers. I am also talking about the masters of psychotherapy.
It would be difficult to describe their work here. After all, even a benevolent silence, a willingness to encourage and to support the mental movement of a patient is also a kind of a question — silent and at the same time the deepest one. «Tell me anything you want.» When I talk about such silence, I mean the empathic acceptance of Carl Rogers, creating a space for safe expression of a client, or a «gap’, the willingness to patiently wait for the manifestations of a patient’s activity, of Arnold Mindell, as a fisherman waits for a bite. A question creates an area of negative pressure that is ready to take into its form what it is waiting to be let out. The task of a psychotherapist is to model capacities for meaning.
Questions are a natural part of the life process
We are going to talk about the questions that people can ask their body, but I have no doubt that the body itself is able to ask questions. In particular, with the help of dreams. Wakefulness is the “answer’ to dreaming. The dream poses a problem and real life serves its solution. You can say the opposite: a dream is a response to wakefulness. The life itself is questions and answers.
Psychotherapy and somatopsychotherapy, as part of our life, does not invent anything unnatural, it does not deal with something artificial. It only cleanses and gives patronage to everything natural.
The terms «facilitation’ and «amplification’ are well known. I use the term «psychocatalysis’. The fact, that psychocatalysis applies to the inner body sensations, became an important opening of the Russian school of BEST by E. I. Zuev and the basis of the development of this «question’ therapy.
«Ask me questions,» a patient often says, dropping themselves into a therapist’s chair (as if surrendering»). Who will do it, how will it be done, and what for?
The Key question
We can say that each system of psychotherapy has its own key question. (This does not automatically mean that it works by questions — and yet…)
The question of clinical psychotherapy: dynamics of what constitutional genetic type manifests itself in the experiences and events of this person’s life?
The question of psychoanalysis: when, under what circumstances, what affection of Id and prohibition by Super-Ego encountered in Ego and provoked the complex?
The question of Jungian therapy: what kind of distortion in the conscious life of the patient makes their subconscious mind «to take measures to equalize the situation» and «what exactly should a person do to regulate their relationship with the unconscious?»
The question of Gestalt therapy: what is the need of the body which makes the «figure’ now, what is the «background’, what prevents the Gestalt from «closing’, what unfinished actions prevent a person from living «here and now’?
The question of NLP: in what modalities and submodalities there is the information that affects a person, how they «manage’ to be upset or, on the contrary, spirited. And so on.
The SPT question
At the diagnostic phase of SPT, a charge that deranges the patient’s consciousness focusing the energy of the body on itself (the substance “heat-heaviness’) is found.
The question that helps to find to this «charge’ is usually very simple: where is the sensation associated with a particular episode of life, with a particular fragment of a dream, with a particular picture, which the patient drew on the instructions of the doctor? At the level of head, chest, abdomen, or anywhere else? Is it something big, small, light, or dark? What is it «made of’? And so on.
Below we will take a closer look at the options of talking to patients, depending on how they declare their problem.
In fact, SPT offers the patients to think about a simple thing: how are their sensations distributed when they solve this problem? Or simply: how are their sensations distributed? Is there anything that disturbs the optimal distribution of sensations in the body? Is anything missing to feel good?
Where does the heat in the arms and legs reach? Are there any uncomfortable sensations concentrated at the level of an area of the body?
I will allow myself a short historical excursus.
Do not wait for any hair to appear on a tortoise shell
Before somatopsychotherapy I had a few years of practice in clinical psychotherapy.
What are its obvious advantages? Firstly, it is the interest in the constitutional and genetic basis on which certain mental processes are developed. A clinical psychotherapist at the first stage of communication with a patient finds out the specific features of the mentality of the latter, and at the last stage they help a patient to see the world as a meeting of different forms of life, each of which has their own purpose. The ultimate achievement of successful clinical work is the patient’s inner peace and tranquility based on self-acceptance as a certain natural entity, endowed with their own character, accepting others as well! «Do not wait for any hair on the shell of a tortoise,» says Taoist wisdom, quite «clinical’ in its essence). This is a substantial part of the work of a clinical psychotherapist, but I would like to draw your attention to something else.
“Storytelling’
A clinical psychotherapist pays much attention to the baseline state in which the communication between a doctor and a patient takes place. Even the most correct messages can be received by the patients only when they have a free resource for this. The fact is that their resources are mostly spent on tension and neurotic experiences.
Johann Schultz is known to have researched and described the basic sensations that a person experiences in the process of relaxation. They were named «six exercises of autogenous training’. A pleasant heaviness and warmth fill up the body then turning into a pleasant lightness and freshness. The heart beats calmly and evenly. Breathing is free and even. The solar plexus emits warmth. The forehead is slightly cool.
The state of the patients when «pleasant warmth reaches their fingers and toes, and the roots of their hair’ is healing in itself. In clinical psychotherapy it is also the background for the patients to accept themselves, the situation and to adjust to a successful way out of difficulties.
It should be noted that sometimes this part of the work is not the second, but the first one: instead of talking to the patient in their «abnormal’ state, the therapist invites them to the session, which is called «learning auto-training’, «hypnosis’ or something else. Only after nonspecific calming in a cozy environment, under the influence of relaxing music, words of «comfort’ with the lulling intonation, and storytelling, the patient is «taken’ to more specific work.
The psychotherapeutic “swing’
At the early stage of my professional development my working combination was conversation plus relaxation. After discussing with the patients their important issues, I offered them to close their eyes and let the feelings to be distributed. Partly, that was the pre-system of the work I am describing now.
Conversation-relaxation-conversation — this rhythm began to seem more natural and important. It is a kind of a psychotherapeutic «swing’. The second part (hypnotic and auto-training) changed its tone in the process of «working out’ this practice. If, at first, I tried to imbue something to the patients at that phase (based on the material of the previous study of their problems), then later I refused to be directive and often offered just to observe the sensations after the conversation, to let them «lie down’.
The questioning observation: question without question
Offering patients to observe what happens after a usual empathic hearing often leads to surprising results. Patients connect to their body sensations, fall into a kind of trance, and undergo a series of transformations, often spontaneously describing the process that, in fact, is organized by psychocatalysis in somatopsychotherapy.
The stones of unease can be detected and disintegrated, sensations can move actively from one area of the body (overfilled) to another (devastated), completely new and optimized contours of sensations can be formed. The convalescents get into the new spaces, from which they come back renewed. It is like auto-training without instructions. Conciliation, calming down, and rebalancing occur spontaneously, in accordance with the «program’, which the body choses itself.
He sat down and began to describe
Recently, I was impressed by a kind of echo of my old “mute’ practice (mute, because it has a minimum number of questions with maximum confidence in own healing process of the body). This story is about the transformations that a twelve-year-old boy began to experience, as soon as he sat down on a chair and heard the words: “Close your eyes. Describe what you feel.”
The boy had a weakened immunity of unclear genesis. He had been suffering from furuncles for a long time. The last two months he was continuously treated for submandibular lymphadenitis (there was a crack in the corner of his mouth, through which he, apparently, got the infection). Two operations under general anesthesia were unsuccessful. He underwent a lot of bandaging, and there was constantly a tubule for drainage in his wound. Of course, he had to forget about going to school.
The boy was brought to me just after he had been bandaged once again. He sat down on a chair and fell into a special state of connection with attention to inner sensations — a kind of trance. He began to describe his sensations in detail without any instructions from me, except for the most general one: «Watch and describe.» The boy understood the main instruction perfectly, though it didn’t say: «Heal.»
The movement of sensations was very intense. The terrible heat was gathering in his chest and there was the feeling of a huge furuncle.
«Will you let him break through?»
«No.»
The boy felt as if he «put his hands in the oven’, then two dinosaurs were fighting in front of his eyes. Then, after a bright flash, everything disappeared.
First, his head «weighed 300 pounds’, then his legs did. Then «a worm slid on his hip and jumped out,» and «a turtle with a small shell, a long neck, big eyes and a silly smile made him laugh’. At last, being weightless, he began to «flip’ in the air.
«Count how many times.»
«Five.»
He began to «flip’ in the air again. This time he had ten «flips.»
A series of transformations, which lasted for about thirty minutes, ended with the formation of a sensation of even heat throughout his body, and the boy felt the opportunity to open his eyes.
A lump of cottage cheese
I was interested in following the outcome of his healing after that process of spontaneous self-regulation. I asked about the condition of the boy in a month. He was healed. Two months later I met him once more.
He maintained balance in his sensations. He enjoyed playing with his friend. «Everything is good. I can play and jump,» he said. Only a small crimson scar under his jaw reminded about his former problems.
«Scars adorn a man,» I remarked.
«I have got enough of them,» my little patient said proudly
The boy reproduced the dynamics of recovery: steady internal heat remained after our meeting. «We were going to take him to the regional center for a more massive operation, but the need for this somehow disappeared by itself. The wounds began to heal,» his mother added. We communicated with him on February 8th, and on March 8th he was already at school. Later his health was improving steadily. His relatives noticed that in he also became calmer.
At the end of my communication with the boy his aunt expressed a desire to talk with me about her problems. It was an indirect sign of recognition of the connection between the session and the recovery by the boy’s relatives. A large lump of fresh cottage cheese, which I brought to Moscow to my children, seemed to me a great reward for my modest question: «What do you feel?»
When you can let happen transformations like those, described by my little patient, nothing else is necessary.
In a few other cases, the challenge is to make the sensations flow. Such transformations are the essence of therapeutic achievements.
Do not talk
To tell the truth, sometimes I almost fall asleep when the patient tries to describe in detail the story of his suffering, not hurrying to work through it. It happens not only to me. In the “Technique and practice of psychoanalysis” Ralph Grinson especially considers such cases when a psychoanalyst accidentally falls asleep during a psychoanalysis session. He recommends not to blame the patient. I can cope with it even without pinching my own hand, but I do not tend to overestimate the effectiveness of this method of psychotherapeutic session and try to warn the patient about the uselessness of just listing the facts.
To avoid this, at the first mentioning of a significant event for the patients, which left a mark in their soul, I prefer to work through the consequent of their experiences, to verify the expediency of its storage, instead of being limited to a simple listing the imprints of events in their soul. I call it the non-slip principle.
Though it is possible to talk as well
However, I must note that there is no need to impose a rather closed, non-objective language of body sensations, when a person calls for an open conversation on existential topics and the balance of their state is not in doubt. Indications for SPT method are very wide, but not unlimited. It is the way to restore the resource of a person. It is needed in almost 100% of cases, but it is not the only thing that the patient may need. Thus, the psychotherapist is not obliged to use the methods of SPT always and everywhere.
We will continue to talk about situations where the balance of the human condition still raises doubts.
The ending — to the beginning
With the time, the phase of communication between the doctor and the patient, conventionally called the “relaxation phase’, became increasingly valuable. I learned to perceive it as a kind of goal, the culmination of the process of psychotherapy,
I once noticed that I was not at all inclined to talk to a patient. Of course, I mean «conversation of minds.» Taking into consideration the importance of the influence of affective charges on a patient’s thinking, I found out that it made sense to «talk to the boss’ (unconscious), in the words of M. Erickson, and not with subordinates (thoughts of conscious mind).
It was easier to find «the boss’ by the sensations in the patient’s body.
The direct appeal to the sensations from the very beginning of the work marked the opening of a unique opportunity to change the state directly, without talking (in the usual meaning of this word). The old formula «conversation — relaxation — conversation’ was replaced by a new one: «relaxation — conversation — relaxation’.
The idea, that the analysis of the patient’s circumstances was usually given an exaggerated value, began to strengthen. In fact, not these circumstances are so important, but how the patient «stands’ in them. It is important to help a person to take a different position in relation to the circumstances, to find another their state. The further is the matter of their own life.
The second phase became the first. Conversations began to start with the analysis of a condition, instead of a situation. Somatopsychotherapy is an exceptional care for the patient’s condition.
Separation of the concepts of “patient’s condition’ and “patient’s problem’
Often the conversation with the therapist flows into the area of discussion of the patient’s problems. I think this is a minimally productive approach. But firstly, let us define what there is besides the patient’s problems.
«The patient’s problem’ is what makes the body react. The perceived information about the situation inside or outside the body, deviates from the optimal. So, the persons consider the restoration of its optimality to be their vital task. This is the basis for their concern.
What is meant to solve the problem is the patient’s state. This is the life resource, the certain configuration of sensations in the body.
Perceptions of situations and responses to them vary widely. What is a difficult problem for one, is nothing for the other; when ones react with all their beings the others can stay completely indifferent. This observation makes you think about the initial state in which a person perceives the situation, evaluates it and forms a reaction to it. The constitutional and genetic factors, the early history of the individual and so on, play an important role in the formation of the patient’s state. It is important that by the time of the meeting with the psychotherapist, the result of the life of this particular person (with his genes, personal history and education) is presented in the form of a state with a certain configuration of internal sensations.
Temperature above 39 degrees
There is a number of situations when the patient’s condition itself (for example, tension) is a problem. As the temperature in case of inflammation goes above 39 degrees. The increase in temperature is natural, of course, but not to such an extent.
Entering the psychotherapeutic room, the patients do not always know what they did it for: in order to solve their problems, or to change their condition. (The third option is the question of how to constructively apply their condition to the problematic situations without changing it a lot). In fact, the problems of the patients are solved outside the therapeutic room. They come here to rate their state of mind in which they try solving the problems and to optimize it.
Psychocatalysis of body sensations is a method of changing the patients’ state and restoring their resources. It is not about solving their problems, unless, we consider the state of their health a special problem. In this case it is a «metaproblem’, the solution of which determines the solution of all other problems.
Separation of the concepts of “psychotherapy’ and “exchange of experience’
It is known that some psychotherapists, including the most authoritative, like M. Erickson or A. Alexeichik, did not shy away from acting as advisers to their patients. There is nothing unnatural in it: a wise person shares with the other one, who is not so wise, their life experience, possibilities, and the program of actions. Such advice of the psychotherapist is distinguished by the fact that it is given technically, “with the special approach’. The instructions remain in the patient’s mind until their full implementation… But it is not psychotherapy — it is an exchange of experience in solving different problems between the experienced and inexperienced persons. The same applies to psychological “problem’ counseling.
We are going to talk about psychotherapy, about helping to change the patient’s state. With such an approach the problems of life will go beyond the brackets. In the field of our study there will be only living beings themselves. The question will be only the following: in what state do they live? In what state do they solve their problems? One of the basic beliefs of the SPT is that it is good to solve problems when the one who solves them is a calm state — which is consistent with the position expressed by Freud: responsible decisions should be taken only after analysis.
The main concern of a somatopsychotherapist is to find what the patients’ resources, their energy, and their attention are being spent for. The work of a SPA therapist can be compared with the work of a prospector. The golden nuggets, that they extract, are the «petrified emotions.» The fact, that they look more like coal, should not be embarrassing. «Gold’, hidden in this ore, is the priceless energy of life, like human life itself is.
Not in blind
Activation of “moving sensations’, such as described in the case of the twelve-year-old boy, is quite common both in the states of “psychic genesis’ and somatic disorders. It is always surprising, delighting and reassuring when the body itself specifies and solves all the issues.
Typically, the sensations themselves are mostly «blind’. As for somatopsychotherapy, the control over this process is particularly important.
First and second level questions
To find out the characteristics of what is disturbing the somatopsychotherapist can go in two directions: the questions of so-called second level require more body energy for the implementation of the reaction, because the expected response is uncertain and creative. “Where is your fear?” — “In the belly”. “What does it feel like?” — “A jellyfish.”
The «first level’ questions are less energy-intensive, and the answers are more predictable. No wonder they are called guiding questions. «Where do you your feel fear: in the head, in the chest, in the stomach, or anywhere else? Is it something big or small, light or dark, heavy or light, dense or soft, or anything else?» You can ask about more details, bringing the questions to the «zero level.» «Does it weigh a hundred grams, two hundred, three hundred, five hundred, a kilo, more, less? Does it feel like gas, liquid, mass, stone, wood, metal, or anything else? Is it an object, a plant, an animal, or anything else?» The series of questions can be continued.
However, to go «below zero’, i.e. to assert something or to impose one’s intuition, is highly undesirable. Unfortunately, this principle is often violated. (And, of course, always with the best intentions!)
“A well working patient’
Being in the “working’ process, a patient begins to understand what is required. The questions become more concise. During one session, already by the third approach (“approach’ means a complete cycle of work; there can be several complete cycles during one session), a well-taught patient can quite “correctly’ answer “simple’ questions. Where are the sensations related to that age? (This refers to the age indicated in the figure in the drawing test). And the patient says, “In the head.” “What is there?” — “Dark heavy mass.” That means that the patient does not need specifying “tips’ such as: “Where are the sensations associated with the exact age: in the head, chest, abdomen, or anywhere else? Is it something big, small, light, or dark? What is it made of…?” anymore.
But even for such an «ideal’ patient some clarifying questions can be appropriate: «Is it in the forehead, in the back of the head, in the crown, or in the temples? How many grams is it? What is its size or volume?»
Somatopsychotherapy “Debuts”
Psychotherapy works with disorders. Disorders can be acute or chronic. Usually the patients come to the first appointment to the psychotherapist when chronic disorders have been supplemented with the acute ones and their life has become unbearable. What does the therapists do at the first meetings? They react to the patient’s acute disorders. What does they do next? They respond to the chronic disorders that the patient often does not realize.
The acute disorder can again occur in the patients when their fate is changing. In general, the probability of meeting an acute state at the beginning of psychotherapeutic contact is higher than in the future.
Why do I mention this well-known to every therapist fact? Because it is related to the topic of this chapter. At different phases of work with a patient, different ’approaches’ will be preferable, different ’debuts’ will be played.
From the actual
The general pattern is as follows: at the beginning of the appointment a patient is so full of different experiences that it is not necessary to look for them, they openly come out and it is easy to work with them. The patients can be quickly turned to talk about what they are experiencing. If they describe their body symptoms, such as ‘a stone in a soul’, it will only be necessary to specify if it is large or small, heavy, or light. If they mention the overloading of their forehead with restless thoughts, you can just ask: how many of them (thoughts) have accumulated there, whether they are large or small, what they are made of in their sensation, etc.
If the patient has previously conducted internal analytical work and managed to identify their condition, they declare fear, which limits their life, or jealousy, which drives them crazy, or resentment, which they do not know how to survive. It is also quite easy to turn their attention towards the description of the body sensations. «Where is your fear: in the head, in the chest, or in the stomach? Is it big, heavy, or light?». As soon as the first answers arrive, e.g. «My fear in my stomach, and it is big», you should immediately ask clarifying questions, e.g. «How many centimeters is it in diameter?», and thus lead the situation in the direction of identifying the plastic image of the experience, located on one of the levels of the body.
The usual dynamics of asking questions is as follows. Suppose that the patient complains to the severity in the chest, or finds there the feelings associated with the experience, which they manage to qualify as an offense. It is essential that the chest area is seen as problematic, concentrating all the sensations on itself.
Without any delay we specify:
«Is the heaviness in the chest big or small?
«Big,» the patient answers.
«How many kilos?» we continue to ask without any hesitation.
It can hardly be called a traditional way. As we have already mentioned, usually a doctor, after taking note of the symptoms, begins to establish a ‘nosology form’ thinking about the pills to prescribe to mitigate the painful manifestations. A psychologist embarks on a search for the psychological conflict that caused the disorder of the client. A healer immediately determines “the influence of an evil eye’ and starts to remove the ‘damage’. We have already talked about many options for the external use of the patient’s message. SPT also offers to continue asking questions and go into more detail about what has already been said. To make it easier for the patient to concentrate, you can offer them to close their eyes.
Closing the eyes, the patient responds:
«Ten kilos.»
«Ten kilos of what: gas? fluids? mass? wood? metal? stone? anything else? What does that feel like?»
«Stone.»
«What type?»
«Marble.»
«Shape?»
«Cube.»
«Size?»
«10 × 10 cm.»
Thus, we receive the initial information.
Please, note that we find out the characteristics of what is really felt. It is not a representation of something that does not exist.
So, in acute cases there are no problems with the beginning of the work, because the experience «strikes’ the energy circuit of a person or, rather, the contour of their feelings so much, that neither the patient nor the doctor finds it difficult to identify the «theme’ for work. The locus of experience also does not require long definition. The head «rips apart’ with the concerns, the chest is «pressed by resentment’, the fear «gathers all the power’ in one’s stomach, etc.
It is not so easy to determine the location of the «threshold’ and «sub-threshold’ experiences. In these cases, some tricks may be needed in order to find them and neutralize. Either it will be a subtle conversation, revealing the «zones of indifference’ of the patient, or something like what I want to describe as a special approach in the identification of hidden problems in the patient’s experience.
From the drawing
The beginning of ‘from the drawing’ is one of the favorites in my practice. The instruction to the patient is as follows: “Draw a symbolic figure of a person of squares, circles and triangles, the number of elements in the figure is 10”. If the patient has additional questions, it can be explained that the total number of elements that make up the figure is 10, but their quantitative ratio is arbitrary. It is advisable to draw without giving it much thought. It is possible to change the size of the squares, circles, triangles.
In some cases, I propose to color the figure and almost always to denote the age of the character. We will not consider the variety of options based on the constructive drawing of the person now. This is a separate topic. Let us examine only some cases of using this beginning. I was shown this test and some of the possibilities it offers by V. V. Libin, to whom I am grateful.
The use of this test in somatopsychotherapy is different from Libin’s expert one, in which the quantitative ratio of geometric figures in the drawing is important to make the conclusion about the main problems of a patient and his personal style.
In our case, this task is used for a completely different purpose — therapeutic. The authors of the expert system recommend asking for five drawings of a human figure at once. In our ’therapeutic system’, this does not seem appropriate. The first drawing is the last one. It means that the state, genetically related to it, is immediately subjected to study.
Subsequent (post-therapeutic) products will be new, and again one picture will be enough to fix the change. I give importance to the age of the character (it is not practiced in the original test). I also use colors for this test.
Below there will be many specific examples of using the drawings. Now I would like to focus only on general issues.
The work with the drawings becomes relevant only after the obvious distortions in the patient’s condition are worked out. Psychotherapeutic communication goes into a new phase — the phase of cleaning the consciousness of ’polluting’ formations’ in a systematic mode. When the patient is generally calm and there are no other emergency topics for work today, then they get the task to draw a symbolic figure of a person of squares, circles, and triangles.
After the drawing is made and the age of the character is indicated, attention is transferred to the sensations in the body associated either with this drawing or (more often) with the age indicated near the drawing. «Where are the feelings associated with the age of N years? At the level of the head, chest, abdomen, or anywhere else?» As a rule, sensations are detected at the level of one of the mentioned zones and it turns out that they are associated with some experience, more often unpleasant, sometimes pleasant, but always significant.
When the first episode of work ends with the patient’s calmness, ’closing’ the old experience, an alternative, more productive response in such situations can be find. As soon as the cycle of work with a separate experience is completed, the same task can be given again — to draw a figure of a person from the already known elements. To give or not to give this task again depends on, firstly, whether the patient has enough strength to do another cycle of work, and secondly, on how much time is left till the end of the session. In case the patient is not tired and there is enough time left, work cycles can be repeated an unlimited number of times. Remarkably successful patients can work out up to 5—10 episodes per hour. But the general rule is one episode per a session.
I recommend paying attention to the description of this kind of work in the Chapter «The Case». There you can see the typical ’growing’ of person from session to session.
In conclusion, I would like to say that starting the recovery process with a constructive drawing of a human figure can help a lot in a systematic work through the patient’s problems during the psychotherapeutic communication. Using the drawings can help the patients to determine what was in the depths of their consciousness delaying their free development. They help to actualize the hidden experiences that seem to belong to the past, but, nevertheless, remain in the present and continue to have a negative impact on the patient’s life. It is difficult to overestimate the usefulness of drawings as an indicator of the patient’s condition when everything only outwardly looks normal.
In cases where the patient is experiencing significant anxiety and is clearly aware of their trouble, the use of drawings becomes unnecessary, even inappropriate. With all the sympathy for them, we must realize that they are the artificial means of obtaining material for the work.
Both in case of work from a conversation that reveals the actual experience, and in case of work from the drawing, the so-called ’principle of non-slipping’ works. The first mention of a significant experience is a sufficient reason to study it. Listening to the enumeration of the patient’s troubles is a useless exercise. To deal with their consequences is much more productive.
From the dream
The starting point for the work can also be a dream. Here is one example of the work “from a dream’ in more details, as no description of this kind is further expected.
The main idea is that any dream as a whole or its elements are provided with a specific charge or their combination. For every dream there is an equivalent in sensations at the level of the body. So, the question is: «Where is the feeling associated with this dream or the dream element?» For example, the patient’s respond is ’in the head’.
The dream of patient P. was determined by the experience of betrayal, and his feelings associated with it were in his back.
From heads to tails
Patient P. is twenty-eight years old. He is not married and lives with his mother. His father, abusing alcohol, died when he was fourteen. At the age of twenty-four he went through a difficult parting with his girlfriend who was waiting for him from to resign from the Navy. He gave up his Midshipman shoulder straps for her. But after his return from military service she decided to leave him. The patient took her statement about their break-up as a blow which caused much pain.
He tried to forget her. He started dating another girl he had been introduced to. Their relations were warm but without love, and their wedding did not take place. Because of that he was very upset, and everything began «to fall out of his hands’.
Being soft and deep by his character, he used to write poetry and paint in his youth. He was also interested in philosophy. But now he has not got any special interests. He complains about «lack of spirituality’ in his life. He says that he does not want to do anything. «There is no purpose in my life. I am waiting for some fairy godmother or social worker to come and help me rebuild myself. I am still a dime. But I was thrown from the heads to the tails,» P. sums up his sad story. Some time ago because of all that background he began to drink a lot of alcohol with his friends to ’feel better’. Once he was stabbed in the heart. Fortunately, the knife hit his rib. He explains psychological gain from such behavior by ’obtaining new information’. Those ’guys’ were the only real opportunity to share experiences.
The characters in his drawings are not all standard. In response to the proposal to continue drawing after the first one was made, he gave almost abstract compositions from the given standard elements: squares, circles and triangles. The third figure in this series was subsequently decoded (Fig. 1). It turned out that it echoes the dream, which was the starting point for one of the episodes of the work. It depicts a sprawled man. «Two holes in him, in and out.»
The dream refers to the period of 1995, when he broke up with the second girlfriend and felt as if something was also broken inside him. «I fell down on a piece of rebar at the construction site and it punched me through.» Some of his dreams the patient perceived as prophetic, so he stopped diving from a high of 8—10 meters, as he used to do.
His dream was rather old, but since the patient mentioned it today, I suggested to ’check’ where he was at that moment: still on the rebar or had already got off it.
«I’ve got off.»
«Was the wound healed?»
«How many percent?» I often use this question in my work. Its undoubted advantage is that it is completely «safe’. In case, «the wound’ is a hundred percent healed, it makes sense, if not a hundred percent — it makes sense as well.
Clarifying the feeling, the patient found out that his wound was not actually healed yet.
«Is there something about her that won’t let it heal?»
«Yes.»
«What is it?»
«Rust.»
«Much or little?»
«Much.»
«What will you do with it?»
«I will throw it away.»
«Proceed!»
While cleaning his wound from the rust, P. noticed that inside it was full of pus, and outside it was covered with a crust.
«What is the diameter of the crust?»
With his hands he showed a circle of a small plate. There was a crust on his back, below the shoulder blades.
«Do you need it for something?»
«No. It keeps the pus from coming out. If I squeeze it from inside, it comes out only in drops.»
«What will you do with it?»
«Pry it off»
He did it.
«Where will you put the pus: in a bucket, in a hole, in a toilet bowl, or somewhere else?
«The pus is running down my back.»
«Has the wound started to heal?»
«Yes. But there are still white streaks of pus».
«How many percent is it healed?
«65.»
«Shall it go on healing?»
«I apply some healing ointment, a bandage, and cover myself with a warm blanket. I need some rest.»
By the end of our conversation, I asked again about the condition of his wound.
«It’s almost healed,» was his answer.
As a rule, back injuries appear because of betrayal («a knife in the back’). In the case of P., it was a piece of rebar. There are also can be other causes of problems in this zone — functional blocks in the vertebral-motor segments (displacement of the vertebrae). Below we will talk about the non-psychic factors involved in the formation of sensations.
From the story about the events
“Now that you have spoken so beautifully about the events that have occurred in your life, I would like you to continue and describe the feelings that you experience as a result.” It seems significant to me. The patients are invited to make a more complete description of their condition.
From the images
If a jealous woman is “driven crazy’ by imaginary scenes of her husband’s cheating (“I go crazy when I imagine her hands on his neck…") — one can ask what she feels when she sees these scenes. Where is the charge associated with her emotion: in the head, in the chest, in the stomach? Is it big or small? etc. There appear a “black funnel’ in the abdomen. The direct correlation between the brightness, proximity of images of significant persons and the size of internal formations existing in relation to them is obvious.
From complaining about other people
“My mother-in-law bothers me”, a young woman complains with tears in her eyes. “What do you feel?” This question immediately turns the conversation from a useless discussion about the nature of the mother-in-law to a discussion of her state that arises as a result. The poor daughter-in-law finds “iron weight’ in her chest (her resentment). Somatopsychotherapy is the option of working with the results of the experiences.
On orders from the outside
An irritable person says: “I have a feeling that the energies of some people, like tentacles, reach for me, and I feel bad.” At the same time, he jokes at himself: “A false psychic!” “What do these tentacles indicate in you? How are they related to you? Why are you visible to them?” It turns out that these “tentacles’ are the assistants in tracking his own charges.
You can worry less
Wives of alcoholics often have an upset contour of their own feelings. They persistently take care about their husbands, but not themselves. The moment when a poor woman is asked: “In what state do you solve your problems?” becomes a true revolution in the life of their families.
Such women should be suggested to check the state in which they try to solve their husbands’ problems considering them to be their own. It helps to switch to the discussion about themselves. For example, a woman is trying to help her husband to stop drinking alcohol and at the same time is experiencing anxiety. She can feel that her anxiety takes away 90% of her forces and makes her almost unviable.
«Should you be so much stressed to solve your husband’s problems, or can it be less?»
«Maybe less.»
«How many percent less?»
«I guess it can be a hundred percent less. Whether I’m worried or not doesn’t change anything.»
«Maybe you shouldn’t calm down because in that case you will do nothing and let events take their course. Should you?»
«I think, on the contrary, I will be able to do something worthwhile, only when I am calm.»
«Well, will you calm down right now?»
«Yes.»
«Calm down and watch how your sensations are distributed. We always talk about the reconciliation of proportions of what we spend our energy on.
The method “to add volume” to the therapy process
Primary care for a patient depends on what they attention are initially focused on. The work on the bodily level usually finds a greater response in those people who have got naturally good feeling of their body, the body of their consciousness. They describe their sensations as an important part of their experience without any stimulation from a psychotherapist.
The ability for such awareness of the problems is an indication for the bodily psychotherapy. However, somatopsychotherapy can be also highly effective with other forms of self-consciousness and, in any case, is recommended as an additional means of «giving volume’ to a therapeutic process. Somatopsychotherapy is a good way of activating self- awareness and working out the physical aspect of the problematic experience, regardless of whether it is the main approach to change the state of a person or an ancillary one.
No matter where to start
There are an unlimited number of ways to start the recovery process: from a posture, from intonation, from facial expressions etc. It always turns out, that such manifestations are found in the body structure.
Fine examples of the beginning from gait features and gestures of a person are given by Arnold Mindell (USA). He organizes the process of «amplification’ of the movement, which tends to manifest, but is hidden. It is on the «lunar’ but not on the «solar’ side of consciousness. The question of the process-oriented psychotherapy is: what are you doing when you are holding your leg in such a way? The answer is: I am preparing it for a fight! The SPT question is different: where is what makes you so tense to keep your right leg like that? The answer is: there is anger in the chest. Thus, the continuation of the work is different.
N. R. Cape (Brazil) offers to pay attention to the characteristics which a person uses to describe the others. His integral psychoanalysis is based on returning to a patient their statements-projections. The SPT interiorization is achieved in a different way. «Is there something that makes you choose such words? Is it at the level of your head, chest, abdomen? What do you feel when you say that?» We move from the projection to the state which is holding it. We talk in a «topographic’ manner, using the question «where?». From nouns and adjectives that are used by a person to define the others, we move to the essence of the «speaker’, to that part of their consciousness, which «invests’ such speech behavior.
Now we will not go into details of somatopsychotherapy «debuts. Let us agree with Jung, who noted that " … in case you want to determine the patient’s complexes, you can reach the center directly from any point of the circle… you can start with the letters of the Cyrillic alphabet, with meditation in front of a crystal ball, with a prayer wheel or a modern painting, or even with a casual conversation about a trifling event. In this sense, a dream is as effective as any other starting event.»
It does not matter which of the rivers will bring us to the lake, and, in a sense, it does not matter what to start the recovering process with. What is important, is how to end it. According to V. N. Tsapkin, we are looking for the «invariant of options.» He noticed that the same mental content expresses itself through the absence of legs in the drawing of a person, made by the patients with clinical symptoms of astasia-abasia, as well as through their dreams, or their behaviors in a group.
In somatopsychotherapy this kind of invariant is the bodily-oriented structure of consciousness. Under other circumstances, a person expresses it in words in free associations (in the psychoanalytic model); projects on the inner screen in the form of «movie’, accompanied by sounds, smells, bodily sensations (in the NLP model); expresses behaviorally (in the procedural model). In a «somatopsychotherapeutic’ situation it appears as an object in the body of consciousness. It is like a book on the bookshelf that can be read, filmed, or performed dramatically (as in the above-mentioned models), but which is now stored in a potential state within its covers.
The direction of asking questions
Two spaces
The somatopsychotherapy questions are topographically structural: “where and what?” at the first stage, and “where to and what?” at the second one. The psychotherapist aims to help the patients find their sensation, associated with the certain experience, in their special internal space — the space of sensations. It is different from the one with the realities of the objective external world. The table which I am sitting at, the tree which I can see in front of me, the sky above me are outside my space of sensations. The space of things and the space of sensations complement each other. Both are parts of the reality of our consciousnesses. The reality associated with the external space can be called “the reality of open eyes’, whereas the internal one is “the reality of closed eyes.”
Psychocatalysis of awareness of the space of sensations reveals three areas of this «psychogenetic’ world which is parallel to the material world.
Three areas of self-awareness
The world of phenomena that opens up when referring to the “reality of sensations’ is rather rich. It consists of in-body sensations, sensations of an integral body, the “landscape’ sensations.
We will mainly be talking about in-body sensations. To begin with, we will mention the «boundary’ and «over boundary’ sensations, for example:
Someone is holding his shoulders up.
«What do you have on your shoulders?»
«A stone.» (or «a bag’, or «a log’, or «a pole with two buckets’, or
«my mother’, etc.)
(This is a state of neurotic, psychopathic responsibility, or concern.)
One more dialogue with another patient — a young woman.
«Who are you?»
«A pineapple.»
«Where are you?»
«On a plantation.»
«Is everything all right?»
«The peel’s damaged».
These are some more examples:
A man stretches his arm along the sofa, which he is sitting on, as if embracing someone invisible. You should ask him:
«Who is there?»
His answer can be:
«A cat. (or «my friend’)
«What for?»
«For calmness.» (or: «to reinforce my position.»)
A man is walking late at night. His right hand is clasped.
«Is there anything in your hand?»
«A gun.»
«Will you shoot it?»
«No.»
«What will you do with it?»
«Throw it away.»
He throws it away and starts to observe “an arsenal of weapons, both modern and ancient, including axes, etc., falling out of it. How about his left hand? Quite primitive tools like cudgels and stones are falling out of there. Disarmed, he continues his way under the highest protection with his hands lightweight and free.
The subjective space of each person, as it is described in this book, is saturated with different things and essences. Each of the elements of this internal world is «alive’ only because of a certain energy current, formed and fed by its carrier.
Perhaps, that is what Jung called «the semantic field», Menegetti — the psychosemantic field, Arnold Mindell — «the field, the area in space, within which the force lines operate», Vasily Nalimov — «the Semantic Universe.»
This work is focused on the phenomena of a person’s self-consciousness of their own mental space, namely, their in-body space. Knowing about the possibility of talking about «hallucinations’, somatopsychotherapy prefers to be interested in what «subsidizes’ their being, what charge is in the body consciousness. «Where is the feeling that makes you get armed?» (The feeling of fear in the stomach). «Where is the feeling that makes you shoulder the burden?»(The feeling of guilt in the chest).
Correlations
Here are some examples of correlation between a person’s awareness of the ‘body composition’, their own holistic image and “landscape’.
A woman feels that the cause of her deathly fatigue, which she complained of initially, is her greed. It comes out in the image of her gnarled hands with claws running into a bag, tied on her wrists, which turns out to be empty. She realizes herself as a rat, carrying everything into her hole.
Another woman has not left her house for fear of peeing in public for about eight years. In her stomach there is the sensation of a hot heavy lump, pulling together all her forces. The rest of her body is completely devastated, cold, and trembling. She feels like a fluffy animal-marten, locked in a cage.
A young man of twenty years old, suffering from inability to satisfy his sexual needs and experiencing failure in dating girls, feels on the hand a bracelet with spikes inside it which hurt him. It is the image of the painful circumstances that do not allow him to obtain the necessary warmth. He says, «I’m freezing, I’m cold!» In his chest there a is a black cloud with the solid black ice in it.
There are also natural correlates of good states that occur at the end of the work. They are usually characterized by a feeling of lightness, loss of body boundaries, merging with space: water, air, etc. BEST, which we have already mentioned, also encourages the identification of these «missing links’ in imaginative perception, both internal and external {«boundary’). («What are you lying on?» — «On the sand.»).
«Who are you?» and «Where are you?» are proven work approaches. But they are not presented in this book. They are additional to the question" What do you feel?». Further we will discuss the approach which I consider to be more effective and shorter. As I will not have the opportunity to illustrate the" Who are you?» and «Where are you?» approaches, I will give one of the examples of this kind of work, not only with diagnostic, but also therapeutic parts.
Escaped from captivity
Patient L. M., born in 1953, hesitates for a long time before starting to tell. “You do not understand… people have this kind of attitude! I fall asleep every time with one wish — not to wake up again.”
She feels as if lying on her stomach with a granite seven-story building crushing her. Her body is flattened, arms and legs do not even move, but her head is able to rotate. What is underneath her? Also, the stone. Her head is in abyss and at the bottom there is a river. The cliff is 30 meters deep. She is in constant stiffness. No medicine can help her.
«When you are clamped down, what do you feel?»
«Complete despair. I have been in this state for several years.»
She recalls the circumstances when she was «crushed by a granite rock’: «I worked at school and always wanted to do my best. (I had studied in a boarding school, and our director who loved and respected very much, used to say: whoever you are — a cleaner, or a minister — you must do your best. I forgot many of her words, but I remember those ones.) With no experience I had to be a class teacher. The result was good. A lot of responsibility. At the same time, I was studying in the university, my daughters were small… and suddenly — a conflict situation. The school has been allocated one place at a seaside resort. My daughter was in the school council. I knew how much she was doing there… Then the question arose, who would go there. They chose the director’s daughter. I started to argue. But the director said to me, «Resign, or we will crush you.» I started to work in a college. I thought it was a promotion. New environment, new job. I was always self-confident. But after some time, I faced the fact that… I must go to a lecture, but I do not remember anything. I was stressed.
After a month I resigned again. Doctors, pills. Even eating was hard. I did not talk. Just slept. My husband was surprisingly tactful. I started talking and smiling. Only a year later I felt better. Since then, as soon as there is a stressful situation, I change my job. I have changed ten places already. I don’t work anywhere for more than six months.»
Back to the actual. It is impossible to stay in the rock any longer, it threatens death. The patient thinks what to do, so do I. Maybe she should call for help.
«Did you try to call for help?»
«What is the use to shout if I know that here people can’t get here?»
«Perhaps, someone will be able,» we continue conversation searching for more real way out.
«My head is over an abyss, the river is roaring, and I hear what’s behind me,» says L. M.
«Should we go in the opposite direction?»
«It’s impossible.»
«Maybe just to relax and to take the weight.» I suggest her (meaning to die and to be reborn, to experience her own death to live).
«This is unacceptable for me.»
It turns out that to get out it is necessary to turn into someone or something, as in a fairy tale. We come to a joint conclusion.
«A stream? A bird? A snake?»
«A stream, going to a mountain river,» decides L. M., but immediately she gets scared. «I can fail to reach the river… But in any case, I start to flow.» She exhales.
«Are you out in an open place?»
«Yes, but my soul remained there. My desire is to take a knife and scrape it off. It is a balloon of some kind… not scraped off. The place, where my body was, is a cave now. My soul is in it, witnessing from above. I cannot see myself. Ball that you have to push, to pull away from those walls. Transparent. It’s like a river of fire down there. I did not notice it before… Maybe my soul is afraid? There is no blue coolness, but fiery tongues of flame, like lava.»
«Maybe you can go right or left, if you change your volume?» I suggest.
«Like whom? An ant!» L. M. exclaims and continues her description. «I get out of this cave (It is a huge space for an ant!) and go right. I see cracks in the ground, on the rocks… A long road. I don’t see any sky, nothing else,» the patient is perplexed.
«You’re an ant,» I guess. «So, you can’t see beyond the surface of the stones and the soil!»
«I’ve overcome a small stone,» reports L. M. and exhales. «But it is felt as a huge mountain!»
L. M. does not understand where to go next.
«Back?»
«No. There is a river below. To the right! Yes, to the right… Now I am in my proper person, trying to go right. No people, no one, nothing. But I have the feeling that, if I go this way, I will reach some place. I must find it… I will walk along this path.»
She finishes the session and opens her eyes, now glowing with a completely different light.
Comment. Identifying the «fairy tale’, in which a person lives, can be productive. The contact with that patient was interrupted for external reasons after a short cycle of meetings. It was obvious to me that the neurotic facade was hiding (or opening?) serious constitutional problems: emotional instability, sensitivity. The leading characterological radical was cycloidal, «expressed’ in her appearance (round face, plumpness). Also, L. M. had a thin neck, which questioned her ability to adapt successfully without supporting work.
Four years later I was talking to her again. L. M. testified that, thanks to our sessions, in many cases she was able to stop her anxiety by asking herself: “What do I feel? Do I feed it or not?” etc., And thus, she saved herself from much stress. However, there was no complete peace of mind. Moreover, six months ago she was in the hospital, being treated with amitriptyline, so she gained weight. She did not have any psychotherapy since then. She worked in two other places. In one case, she resigned because of the difficulties in fulfilling a new job, in the other — because of the dissolution of the company. She experienced increased stress because of the difficulties in acquiring additional skills and qualifications at new places of work and because of problems with her relatives with her daughter.
I asked L. M. to describe her present «landscape’ of feelings. She easily continued the description:
«A high steep bank of the river. The sun is shining ahead. There is a thick forest behind, which is hard to go through. I can go left or right. I am in the state of a deep thought.»
She recollects that for a long time she was thinking about the phrase: «You cannot enter the same river twice» until she decided to talk to her husband. Now she wants to enter this bright river, but the cliff is so high and steep!
«What does this river symbolize for you?» «It’s a symbol of the future.»
«Suppose you are already in the river, what happened?»
«If I went into the river, it would, probably, be easier for me.»
«Why?»
«I would feel saved from thirst and heat.»
«So, are feeling heat now?»
«Terrible heat. My soul burns».
«Coals or open flame?»
«Flame.»
«What your state does of it express?
«Anxiety for loved ones.»
«How many such «alarms’ do you have?»
«Five: unsuccessful marriage of my daughter; absence work and fear of work; the relations with my mother-in-law; worries for the husband, for his health, for my younger daughter.»
«How many percent of your force does it take?»
«Fifty, at least. I am thinking about it all the time. When I am talking to someone and thinking about the problems, my fear is amplified. When I have a pleasant talk (I have a neighbor who can reassure), the flame ceases. When I talk to my daughter, the flames blazes.»
Comment. Note that all the experiences of L. M. are actual and real. Her daughter, for example, is unhappy in marriage. She is in the position of a slave with a stingy husband, who is much older than she and blackmails her, threatening to take away their child.
L. M.’s reaction itself is natural. But the intensity of her worries about the unresolved problems harms her own health and the very solution of those problems.
The diagnosis of cyclothymia in this case is not excluded, taking into consideration the constitutional features of the patient.
As a doctor, I was pleased to hear that she had irrevocably left the «cave in the granite rock’. Her hesitation in entering the river of the future was a problem. Working on her «landscape’, it would be necessary to achieve «smoothing of a cliff’, so that she could feel herself close to water, or in the water.
Although the «landscape’ work can be effective, it is, in my opinion, not the best one. The most convenient way to achieve levelling, «smoothing of the cliff’ is by identifying the feasibility of such worries, by redirecting sensations of heat-heaviness inside the body. The landscape will be changed by inner calmness.
A stone in seaweed
Working with the images “who are you?” and “where are you?” are like working with concentric circles from a stone thrown into water. If you want to get the stone that on the bottom of the reservoir, it is better to dive into its center. The seaweed, growing around, can be mixed up, and the search under water can be difficult.
The advantage of turning to inner feelings is that they convey information about the main thing, which is the state of the one who sees everything directly, not implicitly. Everyone is in the “landscape’, which they are “ready to be in.
Of course, it is possible to perceive circumstances in a synchronistic way, as equal to the state. Zen Buddhists are known to equate the expressions «It is hot, that is why I sweat,» and «I sweat, that is why it is hot» (Alan Watts). This is correct if we proceed from the belief that nothing depends on the will of a person. However, if to adhere to European «active life position’ and choose what depends on a person not indirectly, but directly, the thesis" Start with yourself» still has a meaning. In this case, among others, there can be the question: «Shall I sweat or take an umbrella?»
F. Perls divided «consciousness’ into three zones: self-awareness, awareness of the world and awareness of what lies between those two. He proclaimed the principle of «from the actual.» But what is offered to the patient in therapy is rather the «reality of things.» D. Simkin testifies that in gestalt therapy he seeks to adjust his patient to the perception of what is happening «here and now’. The patients «can see the room in which we are, hear sounds or feel their body, which is comfortable or uncomfortable in the chair, etc.». There is no shift to «unusual’ perception with this approach.
Let us summarize this chapter.
What’s inside is primary
When closing their eyes, people begin to see with their inner vision the composition of their world. There is a correlation between the “things’, which are the charges they carry in themselves, and the world in which they live, their position in it, and their environment.
While exploring the nature of their charges, they can choose what ’to feed’ and what «to turn off’. With this inner transformation they anticipate their entry into the new world. The new world appears as soon as its contributor is ready.
Somatopsychotherapy focuses on the elaboration within the component of bodily sensations.
Characteristics of what is found in the body
In case of introspection, no one found bones, muscles, vessels, nerves, but only a variety of light and darkness, heaviness and lightness, heat and cold, density and sparsity. These are the peculiarities of human self-perception. In rare cases, which apply mainly to doctors or lovers of scientific and popular medical literature, the patients begin to talk about their feelings of, for example, vessels in the head. «Are they thick or thin?» we specify in such an unusual situation. «Are there one, three, five, or ten of them?» Pretty soon, people of such «natural- scientific’ mindset stop to transfer their once acquired knowledge, and move on to describe their real inner sensations in the categories of weight, color, consistency, material, temperature, etc.
The quasi-material
The artist Kandinsky complained that in the physical world there are no colors that convey the colors of the metaphysical world. We can only talk about the similarity of sensations from the contemplation of the first and second ones, but, in any case, not about the identity of impressions. The characteristics of the world of the “open eyes’ are used to describe things of the world of the “closed eyes.” It is obvious that we can talk only about the similarity of what is felt inside as physical pounds, centimeters, and degrees. Things of consciousness are described by the characteristics of material things.
Jung used to say the same about the so-called «landscape’ images. «The principle of conscious life is: Nihil est in intellectu, quod non prius fuerit in sensu. (There is nothing in consciousness that was not previously in sensation (lat.). But the principle of the unconscious is the independence of the soul itself, reflecting its images in its game: not the world, but itself, even if it uses the illustrative possibilities provided by the conscious world to make its images clear (emphasis by A. E.)" In the somatopsychotherapeutic process, a patient also uses «illustrative opportunities provided by the outside world’ to clarify what they are experiencing inside. Of course, there cannot be literal understanding of the patient’s report: «I have a kilogram of wood in my head.» Both the patient and the doctor understand that they talk about sensations.
Heat in the feet
There is a contour of sensations, adequate to each of the normal human states. In particular, the state of rest corresponds to the coolness of the forehead, warmth in the hands and feet, as noted by I. Schultz and as it is advised by the proverb: “Keep your feet warm, and your head — cool.” Joy corresponds to the feeling of being filled with inner light. Love gives the feeling of subsistence of the whole being with warmth and light and readiness to fly.
Being in one of the negative states (resentment, anger, anxiety, etc.) corresponds to the disturbed contour of sensations. Feelings gather in one of the areas of the body, a person’s soul «shrinks’ and «pupates.
A touchstone
In one of the philosophical conversations my opponent declared: “Is there any criteria of truth of life of a person?” I answered him: “Yes, there is! They are the sensations in the body. If the sensations are evenly distributed, the warmth reaches the tips of the fingers and toes, and there are no concentrates plundering the filling at the level of the head, or chest, or abdomen, you are on the right path. But, if there are some concentrates, if the hands or feet are cold (or the forehead is not cool), something is wrong.”
Spinoza said: «Veritas est index sui et falsi» (Truth is the criterion of itself and of lie). This is absolutely true. The even distribution of filling in the body is the «touchstone both of itself and of lie.» However, it should be clarified if the examining is not in winter and not of a long-armed asthenic, the heat in the hands is not a result of the drug or does not occur due to hypersthenic constitution.
I would also include the patients’ relatives in the concept of a «human body’. If in their bodies the sensations are evenly distributed according to their activity, then they live right.
“Heat — heaviness’
Perhaps this is what the Hindus called prana, the Chinese — qi, Mesmer — magnetic fluid, Freud — libido, Reich — orgone, and his follower Lowen — bioenergy.
It is difficult to talk about the nature of this phenomenon. Wilhelm Reich (1897—1957) asserted confidently: «Cosmic orgonic energy exists in living organisms as a specific biological energy. By this capacity it controls the whole organism and is expressed in emotions, as well as in biophysical movements of organs.» However, he decided on it not at once. «What is biopsychic energy?» he asked a rhetorical question. Further he answered: «This question for me, as a clinician, who had to treat sexual disorders in people, in other words, neuroses (Reich equated neuroses and sexual disorders. — A. E.), remained unanswered after 60 years of sexual research in the world of science, 40 years of development of psychoanalysis and almost 20 years of my own work on the theory of orgasm.»
It is known that Reich’s beliefs did not found support in the medical community, although, according to Kelly (1979), nowadays there is no serious work that would refute this theory.
«The brief psychological dictionary», on the contrary, is very concrete in determining the source of energy for emotional reactions: «The level of energy mobilization (activation) of the body, necessary for the emotional functions, is provided by the autonomic nervous system in its interaction with the structures of the brain that makes up the central substrate of emotions.» Further we will discuss the nature of bodily sensations in different emotional states.
For reasons of scientific correctness and consistent implementation of the phenomenological approach, which will be discussed below, I prefer to think about what is felt in the body when experiencing, in a different way. This is a kind of subjectively felt substance that is noticeably collected in the forehead with anxiety, in the back of the head — with overcontrol of the situation, in the temples — with irritation, in the chest — with resentment and grief, in the stomach — with fear and jealousy. I call it «the substance of the heat-heaviness’, or «HH», by the main (though not only) sensations that accompany its movement and concentration. However, the term «HH» sometimes have to be replaced by the more general one — «energy’, because it is the strength of the body response that correlates with the amount of «HH», gathered in a particular place.
This is something that determines the quantitative characteristics of the experience. It is the mass, involved in the experience of «HH», depends on how upset the state of a person. Gathering in certain places in the process of forming of pathological charges, it becomes the source of an unpleasant weight and unpleasant heat. When relaxing, the same «substance’ moves to the periphery of the former focus of tension and determines the feeling of «a pleasant heaviness’ and «pleasant heat’, described by Schultz in the book «Autogenic training». It is the HH substance that is distributed in the body in the process of calming down (we will talk about it at the therapeutic phase), acquiring the characteristics of light, air, liquid or even a thick mass, spreading in all directions, sometimes painful at first, and filling the periphery, like the long-awaited rain, irrigating fields suffering from drought.
The body is the contour map of the soul
The idea that each area of the body is simultaneously a zone of consciousness, is known since ancient times. These are Indian ideas about chakras as special energy centers, which are simultaneously centers of consciousness; Chinese ideas about energy channels in which the psychic energy “Shen’ circulates, etc. The idea of the heart as an organ of consciousness is developed in Orthodoxy. (St. Archbishop Luke (Voino-Yasenetsky); not recognized canonically.
The observations by Ferenczi, Reich and Lowen, who developed the «somatic approach» in psychoanalysis, are significant in the context of this discussion. These authors considered the relationship between muscle tension and mental function in general. Reich formulated the thesis about the functional identity of muscle tension and emotional block. Lowen came to the idea of «functional unity of character and muscle rigidity pattern.» Earlier Freud assumed that «Self» is bodily first of all («Self and Id»): «Self», undoubtedly, is generated by bodily feelings, its sources mainly lie on a body surface». A little later we will mention Henri Bergson, who also spoke about the effects of muscle tension in the process of experiencing (back in 1889).
Those authors, consistently seeking to supplement the «analysis from above’ with the «analysis from below’ (the expression by Sandor Ferenczi), revealed the relationship between the levels of the body and experiences of various kinds. They were mainly investigating in the surface of the body: «relaxation exercises’ (Ferenci), study of «muscle shell’ (Reich), poses, body positions (Lowen).
The “good and evil’ book
Where do the equivalents of different states find their place?
Head:
— forehead — anxiety
— temples — irritation
— back of the head — responsibility, the need to control the situation
— top of the head — osteochondrosis of the spine, «poor nutrition’ of the head (later we will talk about the origin of psychic bodily sensations)
Chest: resentment, anxiety, spite, anguish, grief.
Abdomen: solar plexus area — fear, anger.
Archpriest Eugene Popov tried to present a list of «sins against the ten commandments of God.» In this book there were 1087 pages. If we consider that the beginnings for sins and the beginnings for neuroses are often the same, the list of neuroses may be no less. And each of them «rents’ its area of the body. Each SPT work provides new material for the creation of a detailed atlas of «continents’ and «islands’ of experiences of the human body. Here are the most common ones, although if you want you can make a detailed map of the passions. The body acts as the «contour map’, which describes the location of the structures of consciousness.
The body is a beautiful reference point. In the register of the body marks there could appear even little things like the consequences of undeclared gratitude to the abandoned places (say, school) or discarded containers (boxes, bottles, packages). These areas are located on the sternum below the level of the nipples. Hands from shoulders to fingertips are reference points for recording relationships with trees, herbs, amphibians, birds. If a person uses a tree in their household without a sense of gratitude to it, the right humerus is tightened with a birch bark, and it turns out that shoulder is bound for a reason. If a person once burned the grass, the area of «shoulder girdle’ hurts. The sins to the birds are recorded below in the forearms, to the animals — in the legs.
So, we can assume that the «book of good and evil’, which, according to the beliefs of Christians, angels and demons read on the Day of judgement and where all the sins and virtues of a persons are recorded, are they themselves, the bodies of their souls. SPT, using psychocatalysis, helps the patient «to read’ this book before it is read to them, and to change its content, to decide which pages are to be included
The periodic system of experiences
In the periodic system by D. I. Mendeleev, the qualities of some elements, such as sodium, potassium, rubidium, cesium, are similar. All these elements belong to the same category of alkali metals. However, they repeat their qualities on new registers, having a new core charge and a new number of electronic shells. The commonality of their characteristics is explained by the fact that at the external level of all these elements have the same number of electrons that can connect with other elements. The repeatability of the characteristics of experiences in the human body resembles the repeatability of the characteristics of chemical elements in periods. The experiences are found in strictly defined parts of the physical body. The experience of a seemingly close orientation, such as anger, irritation, anger, differ precisely in the fact that they occupy different “territories.” Irritation is concentrated in the temples, spite — in the chest, anger- in the stomach.
It is known that clinical psychotherapy differs, say, anxiety and fear. What is the criterion of their differentiation? Fear is objective, anxiety is objectless. In SPT, these states, which are distinguished by the patients themselves, show their non-identity in a special way. They are experienced at different levels of the body: fear — at the level of the abdomen (animal), worry — at the level of the heart (soul), anxiety — at the level of the forehead (head).
There are several such «rows.»
Multipolarity of experiences and dreams
In somatic analysis some dreams can be traced to an interesting phenomenon: the different parts of the dreams correspond to sensations in different areas of the body. As an example, there are some dreams of M., a young man, who was prone to drunkenness. He dreams that he is between two slopes of the mountains, in front of him there is a big pile of shit, and behind him there rolls a huge ball.
When asked about the feelings associated with each part of the dream, he replied as follows. The image of «the pile of shit’ corresponds to the feeling in the forehead. There is a plate of parabolic antenna there. This corresponds to his experience of self-concern: «I am aware of it, I understand it. I do not want to get there,» says the patient.
The feeling, associated with the image of «a huge rolling ball’, is experienced in the stomach. There is a huge heavy lump of fear.
The slopes of the mountains, as components of the frightening landscape, are «invested’ by the same charge as «the ball.»
Such observations allow us to admit that the state (which has arisen for internal reasons or in response to an external situation) can be experienced at several levels. For example, a person can simultaneously be anxious (at the level of the head), be worried (at the level of the heart) and be frightened (at the level of the abdomen). Three experiences of one situation — irritation in the temples, annoyance in the chest, anger in the abdomen. Three «images’ of dreams can correspond to them, as a kind of «triptych’ on a common topic.
This phenomenon of multipolarity of an experience can explain the fact that in dreams there are a lot of plot changes that are difficult to explain logically. Such changes can be «a roll call’, «a conference of the centers’ when each of them «reports the situation’ in its own way. The breaks in a dream can be associated with passing «the initiative.» Change of a plot means that «other channel’ begins to show: at first it was, say, the forehead that broadcast the program, then it was the turn of the stomach, and then heart began its program.
This is an alternative to the case where the influence of the centers is summed up and a «landscape’ is created with multiple characteristics, as in the case of M.
Greed and stinginess
It is an interesting fact how differently can a person be influenced by similar disasters, e.g., greed and stinginess. Greed is in the hands (the desire to “grab’ turns the hands into hooks), and stinginess is in the heart (the desire to hold the achieved turns the heart into a capsule). Perhaps such observations can give rich material not only to doctors, but also to teachers of ethics and morality, philologists, and other specialists.
The apparent duplication of concepts in language, according to topographic psychology, is justified by the fact that each word, if it is filled with real content (if its existence is given some life energy of native speakers), corresponds to a special place in the body of human consciousness. Despondency, grief, sadness, sadness, melancholy — it would seem synonymous, but the appeal to the feelings reveals their non-identity to each other (they receive energy from different zones, have different «weight’ and «color’).
The kaleidoscope of images
The perceived formations vary in:
— size — from a pinpoint to larger than the volume of the body
— consistency — from gaseous to rocky
— color — from white to black across the spectrum
— time of occurrence — from a few seconds to decades ago
— the part of the potential, absorbed by this formation — from 1 to 99%
— visualized images — lump, tangle, plate, plate, weights, radishes with a three-meter root and lush poisonous green foliage, jellyfish, octopus, spreading its black tentacles, hedgehog, dragon, bull, aircraft, etc.
Such data give the idea that descriptions of frogs in the abdomen, snakes in the heads, lumps in the throat, bags on the shoulders, etc., given by the unfortunate hypochondriacs, neurotics and psychotics, are not a sign of their madness or neurosis, but represent only one aspect of their state, experienced by almost everyone, including the so-called healthy people, though, not so meaningful and understandable for each of them.
Likewise, looking at the drawings of surrealists with their strange, at first glance, subjects (for example, the body in the form of a chest of drawers by Dali, or deformed bodies by Shemyakin), you come to the conclusion that they are a kind of version of realism, which is the realism of internal sensations (healthy or unhealthy is another question).
It also becomes clear which contours of inner feelings are transmitted in some modern toys and cartoon characters, usually distorted in specific way. What is «secretly’ felt with closed eyes, animators make «clear’ and visible with open eyes. So are the «good’ and «evil’ creatures with too developed chewing apparatus, blindfolded and with a shell on the back, like ninja turtles, etc.
“The layers’
A number of formations consists of “layer’” or composite elements. A woman with elongated proportions of the body (a sign of asthenic type), but quite energetic chin (epiradical) gained a huge amount of “mass’ in the back of her head (responsibility). Obviously, this state prevented her from doing “everything perfectly.” On deciding to calm down, she felt those sensations “departing’ down along her back. The wave passed. But there were some pebbles remained in that place.
«Three, five, ten, fifteen, twenty?»
«No, not twenty, just five.»
«Were they formed at the same time?»
«No, they were added in the course of life.»
«Have a look at one of them and determine when it was «laid’: days, weeks, months, years ago?»
«Five years ago, with the birth of a daughter.»
Likewise, it is possible to define all the aspects related to the formation of a particular element of the experience. It should be noted that patients do not always show interest in this. When one of the elements is determined, it becomes clear what it is about. The fate of such formations can be decided at one time. This woman decided that carrying the stones is not worth it, and she allowed them to roll away.
«Is it better without them?»
«A lot!»
«What are the liberated forces for?»
«For health.»
«Feel how it is happening.»
«I did.» The patient exhaled and opened her eyes. Those are all the issues about stones that remained to be solved.
In the chest there can be «layers’, a kind of «loads’ of experiences, for example, in the form of layers of mica.
A number of formations can be built on the type of «nesting dolls.» Outside there is a layer of younger experiences; deeper one is older and «harder.» Outside, for example, there is rubber, and inside there is iron.
Communicating vessel. The syndrome of “stone-tree’
As a rule, in the process of work, it is found out that the formation inside the body specifically violates the holistic state of the patient. The syndrome caused by the concentration of sensations of heat-heaviness in one of the zones of the body is usually dual. It is accompanied by its second component — the relative depletion of other areas of the body. In my opinion, this is a very significant observation.
In case of «overloaded head’, it can be assumed, that the feet «shrunk.» There is always a kind of combination of «overfilled’ and «empty’ zones. The image of the communicating vessel is quite suitable for the observed phenomena. The «stone’ in the chest de-energizes hands, the «spider’ or «octopus’ in the stomach takes strength from the legs, which can even shake from weakness, and from the head, which ceases to think.
In the therapeutic phase the process takes place in reverse order: calm in the abdomen leads to the filling of the periphery. We will return to this phenomenon later. Now it is important to keep in mind that if the patient talks about the «stony’ head and «wooden’ or «watery’ legs, then we are not talking about two independent phenomena, but about two sides of the same phenomenon.
The axis of interacting sensations can be in all directions: «hump’ on the back means «squeezed chest’ on the front (back-front), head like a snowball means ’dwarf’s legs’ (top-bottom), «a yoke with buckets’ on the right shoulder means «deprivation’ of the left thigh (diagonal interdependency).
Probably, the Chinese contemplate such phenomena as a violation of the balance between Yin and Yang. These syndromes are described as Biao-Li (surface-interior), Ge-Han (heat-cold), Shi Hu (fullness-emptiness), and treated them accordingly, by «heating the cold’, «cooling the heat’, «filling the emptiness’, or «deflecting the fullness’.
The correlation between the verbal testimony of the patient and the indications of the drawing test is also rather interesting.
Libins’ test
The so-called ideographic test, which has been already mentioned above, is used in the work as well. This test was developed in Russia by V. V. Libin and A. V. Libin. A patient is given the task to draw a symbolic figure of a person of squares, circles, and triangles. The number of elements in the figure is 10. As a rule, this kind of a drawing is highly informative.
In connection with the objectives of the study, the test data are used in a special way: on the one hand, as a very convenient beginning of the work, on the other, as a verifier of information coming from the patient verbally. In general, the use of the test is aimed at the tasks of psychocatalysis of bodily sensations. Let me remind you once again that this is different from the author’s expert use of the test data.
More than 1000 patients were examined. Many of them were examined in dynamics. It turned out that there is a clear correlation between what the patients report, referring to the sensations in the body, and what they draw.
The zone of the body, concentrating the sensations now, appears in the figure «marked’ as extension (a circle) or an additional element. The «de-energized’ zone is a narrowing (a triangle). The image clearly represents the distribution of internal sensations in the body. This is especially clear if the patient is offered to draw a figure, and then to calibrate the colors used on the scale of pleasantness, just as it is done in Lüscher’s test (my modification. — A. E.). The most «unpleasant’ color shows the most problematic zone, the most «pleasant’ is a zone with positive potential. A series of drawings, respectively, is a series of problem states of the patient in varying degrees of activation. Double expressiveness — geometric and color — especially facilitates the identification of the locus of experiences. (In this edition the color solutions of patients’ drawings are not reproduced).
Working with images has many clinically useful outputs that allow to use the potential of somatopsychotherapy. Following the main line of presentation, we do not dwell on them in detail. We note only that the patient’s feeling of the composition of their inner space exists independently of the efforts of the somatopsychotherapist and emerges in many objective phenomena. The constructive drawings with their «narrow and wide elements’ are only one of them. The bodily hypostasis of experience is an integral part of the human experience. Accordingly, emphasizing the bodily aspect of the experience is a completely natural way of organizing the patient’s meeting with themselves.
The summary of the diagnosis
Now we have a general idea of what kind of states we have to deal with at the beginning of treatment or correctional work. These states are characterized by a disorder of the natural distribution of sensations, in which the particular locus of the field of experience (or a number of such zones) acquires the status of “plundering’ the filling of the organism, by concentrating on itself heaviness, heat, density, and, thus, simultaneously devastating other zones. That is how specific deformation of the “felt body’ is detected. It becomes, for example, puffy, with a square head, without hands or with a head like a “snowball’, or with withered arms and legs. The fact that the diagnostic results have the form of images which are realized in a plastic form, is of great importance at the next stage of the work. That is what facilitates the decision-making process regarding the found and determined structure of consciousness.
The differential diagnosis
The described method is adequate in relation to the feelings of psychogenic nature. This kind of sensations is only part of all bodily sensations of a person.
There are known practices of this kind. A person has got a headache. Those who want to help them clarify the nature of the pain and learn that «the brain is boiling and about to melt.» What they offer them to do is to imagine putting their brains under cold water. For some time, it changes the patient’s state of health, but soon a headache comes back. This procedure is like the active production of a dream. Freud described such dreams, which he called «dreams of convenience.» Mythical drinking a glass of water leads to prolonged sleep, but not for long, if a herring is eaten before it.
There is also the practice of so-called «visualization’. For example, when working with cancer patients the authors of the technique suggest the following: «When a patient reaches relaxation (it usually takes 8—11 minutes), they are asked to mentally imagine the flow of red blood cells penetrating all corners of the body and feeding organs and tissues. Then the work of white blood cells that perform a protective function is visualized. They detect and destroy harmful particles: microbes, viruses, malignant cells, decay products. The images can be realistic, based on medical books, or symbolic, or even cartoon characters can be used. Some people visualize and draw fights of knights with dragons, or work of powerful vacuum cleaners, or purifying waterfalls. […]
Then the patient imagines a treatment — surgery, chemo — or radiotherapy with a favorable outcome. They see themselves again healthy, happy and full of life. Finally, still in a state of relaxation, with a pronounced alpha rhythm on the EEG, the patient repeats the formula of famous Dr. Que: «Every day in all ways I am getting better and better.»
In fact, it is a variant of autosuggestion. Such work has little to do with direct work with sensations. Though, it is possible effectiveness cannot be denied. One of my very gifted patients
regulated the level of immunity through spontaneously arising images (that woman had constant colds and weakness). She attributed the occurrence of these problems to the need to work with the computer for many hours a day.
«Where are your sensations associated with immunity?»
«In my chest.»
«What is it?»
«Column type thermometer, filled with balls.»
After that, she watched her sensations and went into a state in which the «column’ (or a slide, a pyramid) crawled up until it reached the optimum level. After that the patient was felt better.
The patients with osteochondrosis of the spine often say that someone «gnaws’ their back. «Who?» «A rat.» Here we talk about the experience of sensations of degenerative-dystrophic process. Calming down the «rats’ in one’s back can give the effect, but not for long. Although, analyzing the image of a rat can be interesting in another, figurative way. Who of the surrounding people resembles this rat? Can it be felt so acutely because of the unresolved issues regarding the relationship with that other person? The experiments of A. Mindell (USA) resemble something similar. I was impressed by his willingness to work even with AIDS patients, figuring out the line of relations responding to this type of the disease.
Other external sensations, such as, for example, burning itch in certain places of the body, say, in the perineum, with metabolic disorders due to diabetes, can also be presented by the patient to study. Of course, in this case, we must also understand that real results are not achieved through working with sensations. The relief that is achieved can be frustratingly short-term. Below there are descriptions of some cases that illustrate this thesis.
It is more difficult to identify ephemeral sensations associated with vegetative instability due to traumatic brain injuries. Vertebrogenic effects sometimes imitate psychogenic sensations. They are felt, for example, as spasms in the throat or chest. Some experience and clinical training are needed to differentiate between sensations. Experience comes with work.
However, patients can present to the psychotherapist their precise mental problems…
The asymmetric formations
In some cases (albeit rare) patients tend to interpret their combined sensation as purely psychogenic ones.
The unequal height of the hips leads to the fact that the sacrum sets the non-vertical direction of the spine standing on it. At the level of the cervical spine, there is compensation for curvature in its lumbar-thoracic region. As a result, vertebrogenic «clamps’ (functional blocks of vertebral-motor segments) appear. One of the possible consequences of this is the infringement of the vertebral artery on one side. As a result, a person can feel a half of the head as dark. Moreover, this area, being weakened, begins to experience mental influences. Sidelong glances or angry words will fall into this zone as in locus minoris resistentiae. The imprint of the other people’s rudeness, like a pig hoof, will be there.
I describe this phenomenon only in a few words. I just want to note that if a person talks about asymmetrically located perceptible formations, you should think about either neurology, which can be here, or other influences of not mental nature.
Multiplication of the effects
I once worked with a patient who was at a loss because he could fall and faint from a sharp pain in his hip several times at night. The internists and neurologists stated that there were no organic causes for such condition of that patient.
The patient described his sensation as follows: «in the right (not sick) hip there is a red ball that does not cause interference, in the left one there is a yellow-blue ball of threads the size of an apple. This is the area where the night pain occurs.» The first intention of the patient was to roll out a ball, «turn it into a normal muscle.» But he failed. Then he decided to melt it down.
The bright colors faded, the ball turned into a neutral mass, like wax. The «wax’ flowed down into his left leg, his heel was filled and warmed. The patient breathed out with relief. That completed only the first, «discharging’ part of the work.
«What’s left of the wax ball?»
«Something smaller… a knot.»
«Where should it be?»
«Somewhere outside the body.»
«In the fire, in the water, in the ground, anything else?»
«I guess, it should be burnt.»
«Find the fire and burn it.»
«Do I have to do the surgery? Cut myself?»
«No, you just «show’ it the fire, and it will go there itself.»
«It’s been burnt,» the patient exhales.
«Is it better without the knot?»
«Much better.»
Having opened his eyes, the patient said: «When I was eight years old, we lived in a village. In the summer there were haystacks. We played on those haystacks pushing each other. It happened so that someone had left a pitchfork there. So once, when I fell, I injured myself with that pitchfork. It seemed to be okay. I was vaccinated against tetanus and that was all. I used to tell the surgeon that during the night attacks I felt pain in exactly in this place, but he did not pay attention…»
I found the activation of so long sensations in the almost fifty-year old patient a bit strange. So, I suggested that he examine the kidneys more closely for the presence of stones. After some time, my contact with this patient was interrupted, but from his therapists I learned that his night fainting stopped.
A few years later, from a telephone conversation with that patient, I found out that there was found a stone in his left kidney, but the operation was not performed. There were no more seizures.
In my opinion, in this case there was correlation of causally unrelated phenomena, which should be characterized as random. («Chance is the intersection of two lines of necessity,» said the Russian thinker of the last century G. V. Plekhanov.) The result was not just the addition of influences, but their multiplication. Following another principle: «Success consists of little things», it was necessary to work out all the links of the pathogenesis of the patient’s condition.
«Somatopsychotherapeutic feelings’ can be divided into two groups. There is difference in tactics of working through them.
At the level of sensations, there are two forms of suffering: either an inside charge, frustrating the general contour of sensations, or something from the outside gets in, injuring the «life membrane’ and collecting «HH» around itself. The first kind of States can be correlated with neurotic states that arise gradually, the second one is the result of sudden traumatic lesions. Evolution or catastrophe?
It is necessary to distinguish «evolutionarily’ formed states and states that have arisen suddenly. In the case of «evolutionarily’ emerging states, the psychoenergetic structure of the organism is increasingly being deformed with each subsequent experience, once starting to change itself in a certain direction, under the influence of the «key to the lock’ situation. There is a gradual «accumulation of the affect’ until it leads to the breakdown of protective mechanisms.
Let us consider one of the examples.
A full piggybank
Patient T. A. is a is 61 years old. She is asthenic build, intelligent, endowed with inner strength, and modest woman. The main conflict in the life of the patient is caused by the need to take care of her elderly mother, who throughout her life controlled her and continue doing it now expressing her displeasure. As a result, the patient experiences a condition in which she wants to either “to grab the old woman by the throat’, or to start beating herself against the wall. Therefore, the patient, realizing that such an attitude to her mother is unproductive, still suffers from resentment, anger at the mother, and self-pity. The relations in which others impose their will on her are general characteristic of T. A. She believes that “she must do and collapse’. She says she used to “run forward with bulging eyes.” She considers herself “a criminal’, if she sits down to have a rest for a minute.
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