Bodywork and Transference
I have been committed to bodywork for many years now, having trained originally as a Reichian therapist. I want to talk briefly here about some of the difficulties involved in trying to practice a body-centred psychotherapy, in what is for me the full sense of the word - working with the relationship between client and therapist, and the conscious and unconscious feelings that come up in that relationship.
Although I think psychoanalysis made a big mistake in excluding Reich, and all possibility of physical touch, I also think that some of its reasons for doing so need to be taken seriously. They revolve, essentially, around transference: the feelings from other times and relationships (usually in early childhood) which we unconsciously apply to our therapist - and countertransference: the corresponding feelings stimulated in the therapist, which hopefully can come to awareness and be used to navigate the relationship. The general approach of psychoanalytic styles of work is to keep the situation simple enough that one has some chance of following the complexities of transference and countertransference.
It is clearly true that bodywork - especially when it involves touch - will tend to intensify and complexify all these feelings. Intimate physical contact, in our culture, generally implies one or more of the following: a sexual relationship, an adult-child relationship, a 'making better' relationship (doctor, dentist, etc). This can be enormously confusing for both parties, especially if the therapist is not able to bring awareness to these implications.
They may have the most difficulty doing this around the 'making better' scenario: because bodywork does tend to carry with it a sense that 'making better' is at least part of what is going on - as it quite appropriately is with an osteopath, a masseur, etc. As a psychotherapist, though, I quite explicitly hold the stance that I'm not there to make my clients better, or to meet their needs - only to help them realise what those needs are.
So given that bodywork is, for a number of people, a very effective way of getting to core issues, how am I going to combine it with this therapeutic stance? I've found over the years that it takes a good deal of clarity and discipline to stay clear about relationship issues in bodywork - not to get drawn into a mutual trance where both people are fantasising about their relationship in one or more of the three ways outlined above, and not owning those fantasies. The fantasies are fine, and actually very useful in exploring core beliefs and patterns of relationship - but only if we can look at them openly!
I find that nowadays I am defining Reichian work as centred on breathing and relationship; in fact, as exploring the question: how can I breathe and relate to someone at the same time? This may sound daft, but in reality, whenever we have difficult feelings in relation to someone else, we restrict our breathing in order to keep those feelings down (often quite unconsciously). Alternatively, in order to keep breathing we cut off relating, turning away or closing our eyes for example. Doing both at once, staying open internally and externally, is very demanding, and very valuable to explore.
This approach means that, even when bodywork is explicitly on the agenda, we may never get that far: relationship feelings may become obvious before we do anything else - for example, as the clients starts to lie down it may be clear to one or both of us that there is an unwillingness, and we may spend the session exploring that.
If we do reach the point of hands-on bodywork (which nowadays happens with a minority of my clients), then I have realised that I follow the transference there too: in other words, I tend very much to work with the body issue or body area that carries the greatest relationship charge. That is, I will focus on whatever part of their body wants to do something in relation to me: to hold me, push me away, hit me, turn away from me, be touched by me, fend me off...
By keeping relationship at the centre of the work, I find that I can also keep my clarity about transference/countertransference issues. Although I 'do less bodywork', the bodywork I do is much more focused and useful. Also, it integrates much more fluidly with talking, rather than having the rather abrupt and awkward boundaries that many people experience.
I still find its difficult to integrate bodily and verbal ways of working, even after twelve years of exploration; but I think that the difficulty is a lot to do with the boundaries which our culture seeks to impose on us. It may be hard, but it's infinitely worthwhile!. I do feel that bodyworkers of all kinds, whether or not they identify themselves as psychotherapists, can benefit from transference-oriented supervision to increase their clarity about the relationship aspects of what is going on.
Copyright © Nick Totton 1996
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