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Fifteen of my teenage friends and I sat together in an oak pew to the extreme left of the pulpit,10 rows back. The 90-minute Sunday evening service was plodding along. The reverend, in his regular three-piece black suit, was deeply engaged in his uber-eloquent long prayer that would go on for at least 10-15 minutes. Not really into it, we were restless. Every kid had his forehead resting on the pew ahead, pretending to pray. But below pew height, we communicated with each other by gesture, hoping none of the 400 others in the sanctuary could see us. Then, in the middle of our row one of the guys deliberately started to drool, letting his gob wind its way to the floor and slowly spread into a bubbly puddle. The convulsions began. We fought hard to keep that laugh down. I closed my eyes, backed my tongue into my nasal pharynx, tightened my lips, forced my glottis shut, tightened my chest muscles, tensed my diaphragm, and squeezed everything below that, hoping to keep any sound from leaking out. But 16-year-old boys drooling on the sanctuary floor, stifling a belly laugh? Impossible. The preacher stayed in his fervent prayer until its proper end. And then, waking up from his encounter with God, he turned to us.

Finding my Body

In my 20s my vision of practicing psychotherapy was entirely head-oriented. I pictured myself admired for
lending brilliant interpretations for insight and understanding. But, in the end, the only way I could really become a therapist was through
my body.  I was always a head-type. (Strangely, at birth it was feared I was hydrocephalic, though the final diagnosis was simply, “big head.” According to legend, I fell out of a bassinet at six months and fractured my skull. As an active little kid, I skinned my head when I fell while the other kids skinned their knees.) My speech was not centered in my core. I was not able to write more than a page or two without intellectually meandering. I appeared aloof; to my dismay, some would accuse me of being condescending. I felt inferior, like a fraud, supplicant and all the rest that comes with the self-esteem of a speedbump. It was just too painful to experience consciously, so I denied and projected. It took a long time to recognize the childhood damage of indoctrination, physical punishment and shaming that passed for “discipline,” and official declarations from men in three-piece black suits that I was a sinner with no capacity to redeem myself. Rather than experience the painful and infuriating emotional consequences in my body, I disconnected and went
into my head.

I was much too afraid to volunteer for bodywork. A mentor, who knew better what I needed, pushed me into a training program that required more than 150 hours of work with my body. It turned out to be critical for me to look below my head to physically experience the rest of who I was, to see and accept my real strengths and vulnerabilities.

Radix® Bodywork Foundations

Fifty years after the drooling incident I still use it as a reference. The reader can usefully pretend to be desperately trying to stop an intensely pressing laugh, or a cry. Do it for at least 15 seconds. Feel the articulation of the muscles from the eyes down to the abdomen
(as I described above). Hold it to the point of discomfort. Then, take a moment to allow your mind to record the impression of the involved muscles. If you skipped this exercise, please go back and do it. The natural flow of emotional expression is longitudinal, basically from the abdomen upward through the face and eyes (sometimes with tears). The path of a wild laugh or a deep sob is easy to see. Anger seems to move up the back and forward through sharply focused eyes and sound. Fear appears to move suddenly upward and back with an inhalation, complete with widening eyes and raised arms. Love, happiness, disappointment, pleasure and pain (after the initial clench) all have their natural physical paths of expression. Generally the softer feelings move expansively up, out and forward, while painful
and fearful experiences produce contraction and protection. During the developmental process of growing up we are being “civilized.” Part of
this involves learning to suppress full emotional expression. We do this hundreds if not thousands of times. When we are about to cry, laugh or scream in unaccepting places, we use sections of muscle power to hold it back or to push it back down. Over time, such muscles can unconsciously become fixed into layers of chronic tension. In the clinic we see rigid or highly defended character structures of all types. Properly conducted direct bodywork can safely free underlying emotional flow, like carefully opening a dam allows the fluid to move through.

The suppressing muscles are arranged in seven transverse layers: Around the eyes and base of the skull, around and in the mouth, in the neck and throat, in the breathing muscles of the chest and diaphragm, and on down into the abdominal and pelvic muscles (Reich, 1949). Ellsworth Baker illustrates them as “The Seven Segments of the Body: Ocular, Oral, Cervical, Thoracic, Diaphragmatic, Abdominal and Pelvic” (Baker, 1967). The point of your earlier exercise was to learn about these muscle groups by feeling them within yourself.

For me, grasping the body component in psychotherapy began in 1985 at the Radix Institute, then in Ojai, California. The chief mentor was Dr. Charles R. Kelley, who learned directly from Reich and others, and eventually founded his own institute, revising some aspects of Reich’s work. (For reference see www.radix.org and www.kelley-radix.org.) One principle was working first with muscle tensions around the eyes, always making sure they reflected presence—being in the here and now, not preoccupied or flighty—before working on the next segment below in the “character armor” (Kelley, 1971). In regular psychotherapy, we want the person in good contact with reality before opening a suppressed emotion. In body-oriented work, presence in the eyes is the indicator. Are they spaced-out (withdrawn), staring or flighty (frightened), watchful, or allowing themselves to be seen. With this small sample of the eyes, one can begin to see that psychological defenses manifest in the body as muscular events. And protections are lodged in the muscles of each of the rest of the segments.

Case Study: Nancy

Nancy was a mid-level executive, attractive and competent. She presented with straining eyes and voice. Her history included confusions about men, a depressed outlook under a masquerading smile, and deep, dark, circular ruminations. Such a circle had proven tough to penetrate in regular intensive psychotherapy. When her therapist suggested she take some bodywork sessions with me as a supplement to her ongoing treatment, she quickly declined. With some help she eventually came, suspicious and fearful, pained in her presentation as she spoke about the hopelessness of her therapy and life. Initially, I spent time making contact with her, verbally creating a context for our
work. I framed it as sensory education. That is, I would help her sense ways in which she stopped the flow of energy and feeling in her body so that she could eventually choose either to continue to constrain it, or to let it come through, at will. We followed this with a period of
warm-ups, moving typically constrained muscle groups, learning to stand with unlocked knees, and to breathe through an open mouth,
letting the jaw hang open.

We proceeded to kindle interoceptive awareness (sensitivity to stimuli originating inside the body—see, e.g., Duquette, 2017). At first we adjusted the focal point of her eyes from intensity on the external object (or intensive thought), turning inward and downward toward the wordless, subjective and fluid realm of body processes. 
At my suggestion she expanded her breathing, following her breath down toward her emotional center by sensing the air passing downward through the moisture of her lungs. Further, she learned to experience her relationship to the ground by literally tuning in to the pads of her feet as they related to the carpet fibers and ground beneath. As I instructed her to
allow her weight to fall through her feet, she began to experience and let into awareness the profound reality of gravity, pulling her through the floor toward the center of the earth. As the force of gravity pulled downward through her feet, she (with help) became aware that the pressure was being recorded by the small nerves in the pads of the feet, moving up the longer nerves of the feet and legs to the spinal cord, then on to the brain registry. She became aware of gravity pulling downward, and the sensory awareness of it moving electrically upward at the same time. Tuning in to this process helps set the sensory stage for further inward looking and perceiving. I suggested to her that she let
herself be surprised by what sensations or feelings come up through her body. Body awareness was ignited. A few minutes later Nancy and I encountered each other more closely, face to face, and she was already in good faith letting herself explore in a sensory way the moving
processes within her. She had unlocked basic “talking head” musculature by breathing, unlocking her knees and jaw, and doing a series of exercises to soften her eyes from their alert executive position. At this point we were less engaged in dialog, allowing a more
open and complete presence with each other which some describe as more right brain to right brain. I encouraged her to continue to breathe through her mouth and more deeply than normally. While I stood two or three feet in front of her, she leaned back into a mattress standing against a wall, jaw and knees and eyes still unlocked. I guided her mind’s eye back to her mid-section, simultaneously allowing awareness of her hands and feet, suggesting that the center of her self lay between her hanging hands, above her feet and hips, and below her collar bone. She continued to breathe into this space while recognizing the stirrings within. Her “public relations” smile surfaced only briefly
during this process.

By this time she had acquired enough trust to give me her thick glasses. She didn’t need to watch me so closely. The tension had released enough in her eyes. My attention could now be drawn downward toward some constriction in her throat and vocal cords. When she exhaled, it sounded like the air was being pushed through a narrow pipe. Since I can breathe more openly, I brought her breathing into awareness by comparing her exhalation with mine, then asked her to imitate mine. After a few tries, she succeeded and continued this more open breathing without losing the presence in her eyes. This provided a path for her to open herself a little more, so I moved her to a floor mat, lying down, with me sitting on a low stool by her side. At my instruction she brought her knees up, feet flat, taking some pressure off her lower back. She continued to breathe, open-mouthed. She remained easy in the eyes with me, as I was with her. I felt privileged that this fearful person was allowing me into this more vulnerable place.

Her eyes had adjusted enough, and her breathing had opened enough to be more aware of her internal process without losing contact with me. I noticed a stillness in the rest of her body so I suggested making strong arm and leg movements—pounding the mattress with her fists and feet to engage the rest of her body and build the energetic charge throughout. She completed this movement, and let her body settle in its own time from the effort. When she was restored to full and restful presence, I asked her permission to touch muscles on her face. She granted it, trusting I wouldn’t hurt her, and I placed adjacent fingers on the high end of her upper lip where it met her cheeks (the smiling muscles) gently pressing into this area on both sides of the nose to lessen the tension there, remaining steady, on the crease, while encouraging her to continue breathing fully. This area is a boundary between the ocular and oral segments, likely the place where she unwittingly stopped body awareness and kept things stuck in her head. In less than a minute deep sobs burst forward, heaving up from the bottom of her belly. I encouraged her to let this expression run as long as it needed to and to simply stay out of its way. In about 45 seconds it started to wane. Within a minute or two she recovered her breath and regained easy eye contact with me. Incredulous, she blurted, “How’d you do that?” Staying easy and gentle, I said, “It was you who did that.” In this instance Nancy had a deeper and fuller emotional experience and more expansive expression than usual, whereas previously she had had narrow experience and constricted expression. The expressive door from the core up and out through the face, eyes, and mouth had been clamped. Now she lay there with the door open. At this point
I simply asked her to let her senses passively record all the physical sensations of this new, open, non-thinking, but experiencing body.
A while later, when the session was officially ending, she expressed much gratitude and took the experience back to her regular therapy, where she has enjoyed deeper responsiveness and participation in the group process.

Conclusion

Nancy’s work addressed her unique tensions in her ocular, oral, and cervical segments. Her bigger breathing loosened her diaphragm and abdomen. After the initial contact, the order of the work was essentially top down. When opening the breathing, it is common that tensions typically blocking emotional awareness start to present themselves, giving the body-oriented therapist points of access. Each person is different, and the sense of who they are and how their body operates in the world is broader than I can describe here. But the particulars of Nancy’s work give a sample of how working with the body, conscious of the segmental nature of the character structure, can be helpful to
an ongoing therapy. My aim in bodywork is not about me changing the client. Instead, it is about awareness and freedom. It is about placing and replacing attention on the sectors that inhibit emotional flow. We cultivate an attitude of curiosity and learning, through the sensorium,
about this totally unique self, and we do it one step at a time. Done properly, people really learn to accept themselves as they operate in the world, gaining the sensory knowledge that can offer freedom to change. Along the way often come a sense of empowerment, a sense of aliveness, and a sense of being a unique part of the creative process in nature. All in all, competent work with the body over time, whether it’s for personal growth or in support of psychotherapy, slowly releases the flow of the life force through that person.

Safety Caveat

I add a word of caution. Body psychotherapists have to be settled in their own bodies before they can clearly respond to the impulse, movement, coloration, and breath of the client. It can be hazardous to experiment in your practice with what I described here, except maybe
the kindling of interoceptive awareness, if your client can take it. While I believe bodywork is universally needed in therapy, the specifics of a session depend on accurate diagnosis, accurate perception, and accurate intervention. There are methods that can be learned. Half the learning is through one’s own body, where a sensory recognition of the other makes its imprint. The other half is learning a coherent theory for context. And, personal boundaries, of course, have to be clear.

The Radix Institute (www.radix.org) still operates. About a dozen other schools gather at the U.S. Association of Body Psychotherapists (www.usabp.org). Questions and further inquiries are welcomed (ronhook@gmail.com). 

References
Baker, E. (1967). Man in the trap. New York: Macmillan.
Duquette, P. (2017). Increasing our insular world view: Interoception and psychopathology for psychotherapists.
Frontiers in Neuroscience, 11, Article 1:35.
Kelley, C.R. (1971, 1980-81). Segment one program, a pre-training Radix course (unpublished).
Reich, W. (1949). Character analysis. New York: Noonday Press

Ron Hook, LMSW, practices north of Detroit and travels to do
quarterly body-oriented sessions with ongoing patients of other therapists.
He has practiced individual and group psychotherapy for 40
years. He learned Radix® bodywork in 1985 as an adjunct to psychotherapy,
and so is fluent in both. He is a faculty member at the Institute for
Individual and Group Psychotherapy in Southfield, Michigan. ronhook@gmail.com

“This article previously appeared in Voices, the Journal of the American Academy of Psychotherapists.  Vol. 53.  Number 1.  
Copyright [2017]