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The neglect of the body in psychotherapy

by Allan Rudolf(more info)

listed in bodywork, originally published in issue 16 - December 1996

This month's column continues on a theme discussed in a previous issue – the interactive aspects of Bodywork and Psychology. Like that previous article (issue 14), this is a collaboration between myself and Dr Sheldon Litt. Dr Litt trained with the founder of Gestalt therapy, Dr Fritz Perls, and is the author of Humanistic Psychology and Gestalt Therapy (in Swedish). He is in private practice and offers seminars.

It is well known that most psychotherapists, and especially those of the psychoanalytic school of Sigmund Freud, frequently neglect to pay attention to the physical side of life. The classic example, of course, was the tragic case of the great American composer George Gershwin, who died at the age of 38 in 1937.

Gershwin had complained of headaches, so he ended up on the psychoanalytic couch, since Freudianism was a growing trend among New York intellectuals and artists at that time. (If only he had had the proper advice to first check for physical causes, this musical genius – one of America's leading composers – might still be alive today.)

The psychoanalytic treatment, based on a symbolic interpretation of the physical symptom, did not, of course, help Gershwin's headaches; in fact, they became worse, and after a relatively short time he died of a brain tumor.

There are many shocking examples of such criminal neglect in the unspoken annals of psychoanalysis. Many are pointed out in some of the newer books which dare to criticize the Master of Vienna: R Webster's Why Freud was Wrong, for example, points to many of Freud's own cases that were misdiagnosed – what Freud interpreted as hysterical neurosis was often a case of neurological disorder.

Modern day psychotherapists claim that they are more aware of possible bodily symptoms as important factors, but often this is only done in a cursory manner.

A famous joke, which will put the situation in perspective is as follows:

A man has been seeing an eminent psychoanalyst for years. One day, he looks closer at his "guru", and blurts out suddenly; "I don't know why I go to you for help – look at you; you're 30 pounds overweight, you're sloppily dressed, you smoke smelly unhealthy cigars which leave ashes on your threadbare tweedy suit. You're constipated, smell bad, and even have bad breath. All in all, I'm in better shape than you are!"

The analyst, unshaken, eyes his patient, and answers sharply: "That's because you have a better analyst than I had!"

Such is the core truth of psychoanalysis – whether Freudian or Jungian – the analyst, the so-called Expert, is always right; and the patient is placed in a dependent, inferior position. This used to be called "one upmanship" some decade ago (from a book by Stephen Potter).

FM Alexander, founder of the Alexander Technique, made an astute judgement early in his career. Observing the misshapen bodies of many psychoanalysts, he questioned the efficacy of the Freudian method as a treatment modality.

How is it then that so many mental health professionals have failed to give the body its proper place in their work? A large part of the problem rests with Freud. He trained his followers to focus on something non existent: a mere abstraction he labelled the "unconscious." The more one neglects physical reality to ponder the nature of a speculative non-conscious realm, the more one loses touch with the concrete physical reality expressed by the human body.

Following Freud's teachings (or cult, one might say), generations of psychologists have lost touch with their own bodies and the bodies of their patients. Remember, as an existential philosopher aptly stated: "The unconscious of the patient is, more often than not, the conscious theory of the analyst."

Now, there is no proof for the existence of the unconscious – critics have called it a "blank cheque" that can be filled in with anything; it is only a theoretical notion dreamed up by Freud. Unfortunately, due to Freud's powerful speculations and creative writing skills, he was able to convince enough people of the reality of his abstract conception. Several new books now point to the false ground of these basic Freudian ideas: along with Webster, other new critics are Frederick Crews, The Memory Wars, and R Wilcox, Maelzel's Chess Player: Sigmund Freud and the rhetoric of deceit.

The Jungians are no better; they have their heads in the stars and stir up mystical longings. One modem school of psychotherapy, founded by Fritz Perls and Paul Goodman, on the other hand, stresses the importance of mind-body interaction. By staying in the "Here and Now" (and not digging up Childhood Memories, as Freudians do) Gestalt therapists are able to integrate body functioning into a comprehensive psychotherapeutic system. For the body is always in the Here and Now.

Perls' Gestalt Therapy is based on an holistic theory, stressing the unity of mind and body. For Gestalt therapists a major part of the therapeutic session is for the patient to develop greater contact with his body via various self-awareness exercises. In fact, Perls' description of neurosis includes the body: a typical neurotic is marked by unaware proprioception and hypertonus of muscularity (see the basic book, written by Perls, Hefferline & Goodman Gestalt Therapy).

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About Allan Rudolf

Allan is a Rolfer and Feldenkrais practitioner and trained with both Dr Rolf and Dr Feldenkrais. He now lives in China and is not contactable.

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