BODY PSYCHOTHERAPY WITH COUPLES: USING THE SEVEN DEVELOPMENTAL STAGES MODEL OF BODYNAMIC ANALYSIS

by Anne Isaacs, LCSW, and Joel Isaacs, Ph.D.

Recently one of us was asked to participate in a panel on body psychotherapy with couples that was focused around a hypothetical vignette. We would like to use this vignette and our response to it as an introduction to how we use our training as Bodynamic Analysts when we each work with couples. First we’ll give an overview, then say what we would scan for, and then discuss what our particular body psychotherapy perspective brings to this situation. We will then discuss the vignette and our response to it. Then we will present a case history that allows us to go into more practical detail about how we bring the client’s body into the psychotherapy.

Overview of working with couples

Our personal and professional experience is that we all want intimacy and we are all simultaneously ambivalent about it, at least at some level. Intimacy is wonderful, and it can also be very disturbing since it can bring up too many feelings, especially strong early ones. This polarity, this push-pull, this structural contradiction, this cosmic dance is what brings many couples to therapy. One cornerstone of our Bodynamic approach is the concept that a central aspect of human life is the seeking of what we call “mutual connection”.  Most simply the “mutual” part is conveyed by the question “Can I be all of myself, and you be all of yourself, and can we still be connected in a caring way?”. It is our understanding that when there are stresses or breaks in mutual connection that the infant or child, in order to maintain or restore some connection, will distort himself in ways that lead to the patterns we see in adults. How these disturbances play out in later life is often the focus of our work with couples. Each person in a couple has qualities that the partner admires and would like for themselves. Often some of our deeper issues and stronger feelings may only arise when we get close to someone, when we are intimate. And, at these times, it is often difficult to separate one’s own issues from what is a reaction to the other person’s behavior. We keep in mind that the issues and feelings couples bring in may not be ones they are familiar with or can presently own.

If we broaden our vision for a moment to examine the social context in which couples operate, we can see that individuals in our society generally come together as a couple to find love, peace, security, and fulfillment, and often to raise a family. Of these, the most widely talked about is love. When we ask people what love is they often say love is a feeling, and it turns out to be a feeling that lacks a precise definition. But how is it that something so many people want can’t easily be described? Perhaps this is one source of the difficulty in obtaining it. We are seeking, sometimes desperately, a feeling that cannot be precisely defined. (But, “You’ll know it when you feel it”.) Sadly, this definition of love as a feeling is only one part of love, some of the time.

Love is not an instinct that rises up in us, and love is not an emotion. Feelings always come and go, and we would not normally make a long term commitment based on a feeling we know is temporary. Love encompasses acceptance, compassion, and empathy, and loving someone will help us to open our own heart. A fuller, deeper, more useful idea of love knows it as an act of will, a choice, a decision, a promise even. The practice of love is perhaps best understood as the will to extend oneself for the purpose of nurturing one’s own or another person’s spiritual growth. A loving relationship requires us to extend ourselves, to commit to open and honest expression and communication. It requires us to both show and expect: care, affection, respect, responsibility, commitment, and trust. Love is as love does.

How might a view of love as an action and an intention help individuals in a relationship or seeking one? They could begin by seeing loving as a practice of putting their partner’s interests on an equal footing with their own. They would understand that work and challenges will be involved if they are to maintain and deepen the connection made possible by their original connection. They might even come to see the appearance of difficulties as a possible sign that their relationship is maturing, for often, in the embrace of intimacy there is space for early wounds to surface. As therapists, we see this perspective as both helpful and motivational, both supportive and challenging, and we try to impart some of this vision to couples whenever we believe it is appropriate.

The initial session

In the initial session, we believe the couple’s first impression of their therapist is very important. Here they should be evaluating whether they feel seen and accepted. However, their evaluation of us will often have a component of each deciding “Whose side is he/she on”? Or, alternatively, out of fear of their own issues, they might find it safer to come together to reject us. So it is  vital for each of the couple to have the experience of being heard and affirmed by the therapist. Secondarily, at whatever level they can take it in, it is of great value for each person to witness their partner being heard and affirmed. Perhaps they can begin to understand some of what the other needs, and to witness the relaxation and decrease in tension that can occur for the partner when they get it. This opens the door that separates their closed place of stuckness from the possibilities that lie outside.

There are many avenues that can be pursued at this point in the first session, and many of the initial impressions we get would go into making the choices. Often what they bring in may want some immediate attention. Sometimes an action or expression of one, or a dynamic between the two, will allow an entry to a core issue. Meanwhile, we try to assess their levels of commitment to each other and to the therapy process, their levels of intimacy and of self-awareness. We also try to assess each person’s ability to stay connected with their center, and their ability to maintain a boundary when in interaction. In the latter case we might suggest they explore changing the distance between their seats so that they might better sense themselves clearly. We might want to focus on one and then the other, or we might want to have them engage in a dialog. We might bring in some physical action, or we might decide to keep the session verbal.

A Bodynamic Analytic view

But let us now move on to what is more uniquely from our perspective as a Bodynamic Analysts. The Bodynamic System combines depth cognitive psychotherapy and an emphasis on relationship, with new research on the psychomotor development of children. The body is integrated into the therapy through our knowledge of the psychological function of each muscle. The resulting developmental understanding has been elaborated in a form usable by psychotherapists, a model of Seven Developmental Stages. This model is based on over twenty years of empirical research on how mind and body are connected. It contains a lot of specific information to be used as a guide. In work with couples, we would be very attuned to whether either or both persons were predominantly acting from one or perhaps two developmental stages. We would get clues towards this from their body structure and posture (e.g. as they walk in, how they sit), their energy and vocal style, their choice of words and phrases, and of course from the issues that they raise and how they present them (e.g., Macnaughton (1997). This information begins to direct our attention towards what we should suspect to be their underlying issues, and how we might respond to them. Their responses to our initial offerings tell us whether we are on the right track.

Let us devote a few pages to our character structure model of Seven Developmental Stages. A character structure model is a psychological description of a developmental stage, and a guide to how difficulties encountered in infancy and childhood may be carried over into the present and influence adult functioning. Character structure has some of its roots in Freud’s ideas about oral, anal, phallic, latency, and genital

stages, and was later developed by Erik Erikson. Wilhelm Reich (1949), a student of Freud, worked with Freud’s ideas and included more body characteristics for each stage. Further work from a body perspective was done by Alexander Lowen (1958, 1975) in the 50’s and 60’s . In these latter descriptions, character can be recognized from body posture and structure, as well as from attitudes, defenses, and issues presented in therapy. This early work sprang from the observation that when children are frustrated in an activity they may develop a chronic tension in their muscles to hold back that activity. Working from a complementary direction, Lisbeth Marcher (1992) and her colleagues realized that flaccid or under-elastic muscles correspond to impulses, insights, and skills that are mostly absent or only partially learned. This, they found, is the body counterpart of psychological resignation.

One contribution of Bodynamic Analysis was to extend the character model to later years by identifying seven discrete developmental stages. Subsequent empirical research at the Bodynamic Institute, Denmark, linked each muscle with its psychomotor task, and with the time in development when the muscle first comes under voluntary control. It is at this time that the elasticity of the muscle becomes imprinted (over-, under-, or normal elasticity). Since specific groups of muscles correspond to the developmental tasks of specific stages, it is possible to get an overall reading for each developmental stage. This led to the recognition that there are three possible positions for each stage, and led to a greater clarity in the description and characteristics for each stage (See Bernhardt and Isaacs, (2000)).

The seven developmental stages span the time from the second trimester of pregnancy through twelve years of age (Appendix 1, and Bernhardt et al, (1995, 1996)). Each stage has some time overlap with the stage j