Psychotherapies Without Feeling

by Dr. Arthur Janov

Posted June 2005 on

Chapter 15: Body Therapies: Mistaking Effects for Causes


The body therapies popular today fall under the category of "holistic medicine."  They are based on a belief that the body forms armor or tension around repressed feelings, and that the way to help a person regain feeling is to attack that body armor. According to body therapists, the armor distorts posture and motility, and it also traps emotions and restricts emotional expression.  To attack this armor and achieve relaxation, patients pound pillows, have their muscles prodded and kneaded, are forced to gag to ease throat tension, and so on.  Body therapists believe that restructuring the body by removing the armor not only relaxes the person physically and restores his posture but makes him more spontaneous and expressive and more able to experience joy and pleasure.

Because of the physical aspects involved in reliving Primal Pain, Primal Therapy has sometimes been equated mistakenly with these physical therapies.  In actuality, holistic body therapies and Primal Therapy operate from opposite directions, as I shall explain below.

Prominent body therapy theorists, like proponents of many of the other therapies already discussed, confuse cause and effect. They believe that tense muscles cause tension rather than understanding that it is tension in holding back repressed feelings that causes tense muscles.  This simple but fundamental error leads them to treat the symptom of tense musculature as the problem rather than as the result of a problem.

When the dentist drills your teeth you may clench your fists. You are tensing up against the pain.  The problem doesn't result from the clenched fists but from the drilling.  And you must look to the drilling, not the clenched fists, to get at the problem.

A great deal of effort goes into massage and manipulation of special muscle groups without a thorough understanding of how those muscle groups tie into the brain.  It is from the brain that the energy of repressed Pain is rerouted into the musculature, causing muscle tension, shallow breathing, pained facial expressions, shifty eyes, restricted gestures, and posture which might be tense, guarded, aggressive, wilted, and so on.  Be it chronic muscle tension, chronic emotional distress, or neurotic ideation such is that God has "saved" you, one is usually dealing with rerouted and disconnected Pain from material (memory) stored in the brain.  It is no different than trying to change a paranoid's ideas.  His ideas are the result of the clash between giant forces of Pain and repression.  Ideas are not the central problem; nor is body armor.

This is not to deny that there is such a thing as "body armor," "tense musculature," or what Wilhelm Reich called "muscular-character armor."[1]  One commentator describes certain kinds of body language which give clues to their underlying meaning, as follows:

The body 'holds' injunctions, prohibitions, parental programming, and adaptive decisions, which may be revealed in posture, style and quality of movement, voice tone and variations (e.g., sighs), breathing, the eyes and the way a client looks at others...Some people keep their heads lowered as if they were carrying a load; others strut with their heads held high as if to challenge the world.  Some crouch in corners and whisper, as if to camouflage themselves, afraid to occupy space or to make themselves seen or heard; others display themselves through seductive glances, voice tone...The body is the guardian...of the most deeply hidden or denied feelings.[2]

I agree; there are certainly people who do defend with their bodies.  Some of these people, the ones who are as physically stiff as they are emotionally repressed, when forced to move in a loose way, become undefended and the Pain does rise -- but that's the point.  Distorted posture and tense musculature are, in effect, "guardians" of "deeply hidden or denied feelings."  Any kind of manipulation of the "body armor" should lead not to the liberation of body tension per se but to the liberation of feeling.

The holistic health movement, with its mind-body connection ethos, has unleashed a great deal of talk about how various therapies release the "free flow of emotional energy."  This may be a very nice image, one that borrows from Chinese medicine's notion of "chi" (vital energy or life force), but one that, like the traditional Chinese view that chi flows along a systems of internal conduits and meridians, hardly corresponds to any physiological reality.  Which is not to say, of course, that there is not a mind-body connection, nor that tense muscles do not express emotional trauma.  There is, and they do.  Nevertheless, before trying to undo the effects of neurosis, we must properly understand its source.  And since neurosis is not caused by tense muscles, body armor, or whatever you want to call it, there is no facile transformation of the brain and of deep-rooted feeling to be had by manipulating the body.

Think of the body as an energy-processing thermodynamic unit. If the energy of repressed feelings is bound up into the musculature, and if the musculature is then loosened so that the energy is temporarily released, the energy must go elsewhere.  For without conscious connection to the real source, it can only be rerouted. This is because in using body work to release muscle tension (or in using needles and massage techniques on certain "pressure points" in order to get one's vital energy flowing  correctly), we are dealing with derivative energy, just as we are when we deal with phobias and bizarre ideation.  They are all derivatives of Primal events that were symbolized and rerouted in the service of repression.  To deal with derivatives is to remain on the fringe of the problem, which leaves the problem virtually intact, even if rearranged and re-sorted.  It may flow out of one bundle of muscles, but from there it will flow into other channels which will produce measurable affects such as quickened heart rates, heightened blood pressure levels, and elevated brainwave amplitudes.  It will produce symptoms and disease -- headaches, allergies, ulcers, heart problems -- rather than magically give way to the "free flow of emotional energy" or to a newly "centered" individual whose chi flows freely.

In my experience, serious loosening of the body armor often results in crying jags by the patient but she knows not why she is crying.  It is basically abreaction, which cures nothing.  It does release, however, so that the person feels better for a time.  Yet it gets addicting as the person comes back for more:  his fix.  At least it is a method of release from being all bound up.

Of course, massaging certain tense muscles can and often does make a person feel better.  No doubt you can reduce emotional stress for a time by manipulating the body in any number of ways, from massaging someone's cranium to kneading and poking the soles of his feet.  But one must not confuse palliative help with a deeper resolution of causes.

It is essential to remember that when one puts a finger on a chronically-tense muscle, one is actually putting a finger on a memory.  In a sense, manipulation of the musculature is truly a manipulation of the brain -- only in reverse.  This is another way of saying that the body is hooked up to the brain and is not an entity unto itself.  It is not body manipulation that we are doing, but brain manipulation.

Let us examine three different body therapies which have been popular and influential over the years:  Reichian Therapy, developed by Wilhelm Reich; Bionergetic Therapy, developed by Alexander Lowen; and Rolfing, developed by Ida Rolf.  Some of the types of body work which have come into vogue in the stress-reduction field in recent years -- be it Swedish massage, shiatsu (which "unblocks" and "rebalances energy flow"), deep tissue massage, reflexology, CranioSacral therapy, Trager -- have commonalities with these prominent theorists and body therapists of past decades.  Thus, while this chapter is certainly not an exhaustive exploration of body therapies, it critiques some of the more important strands of theory and practice.

Wilhelm Reich and Reichian Therapy

As a Freudian-trained psychoanalyst in the 1920s, Wilhelm Reich became interested in the way a person's attitudes defended him against repressed feelings.  He began to see patterns in these attitudes and developed a method of analyzing them which he termed "character analysis."  During this same time, Reich became convinced that sexuality was the key to the cure of neurosis -- not surprising, in light of his Freudian background.  He believed that unreleased sexual emotions supported neurosis, and that their release would bring about its collapse.  "Full orgiastic potency" was the means by which the blocked energy that constituted neurosis would be freed.

Reich developed the physical part of his theory in the 1930s. This placed him clearly outside of traditional psychoanalytic thought, similar to what had happened to Fritz Perls when he broke away from Freudian orthodoxy.  Convinced that neurosis was more bound up in the body than in the intellect, and that there must be a physical counterpart to one's "characterological defenses," Reich pondered the possibility of something he termed "biophysic energy."  He was convinced that a tangible explanation of the physical aspect of psychic events waited somewhere in the laws of physics.  In 1933, while treating a highly-resistant patient, Reich made his breakthrough observation:

After an energetic attack upon his (the patient's resistance he suddenly gave in, but in a rather alarming manner.  For three days, he presented severe manifestations of vegetative shock.  The color of his face kept changing rapidly from white to yellow or blue; the skin was mottled and of various tints; he had severe pains in the neck and the occiput; the heartbeat was rapid; he had diarrhea, felt worn out, and seemed to have lost hold.  I was disturbed.  True, I had often seen similar symptoms, but never that violent.

Something had happened here that was somehow inherent in the therapeutic process but was at first unintelligible.  Affects had broken through somatically after the patient had yielded in a psychic defense attitude.  The stiff neck, expressing an attitude of tense masculinity, apparently had bound vegetative energies which now broke loose in an uncontrolled and disordered fashion...Such a reaction presupposes a continuous inhibition and damming-up of biological energy.  It was the musculature that served this inhibitory function.  When the muscles of the neck relaxed, powerful impulses broke through, as if propelled by a spring.[3]  [Italics Reich's]

The patient "lost hold," Reich reported; "bound vegetative energies...broke loose in an uncontrolled and disordered fashion." I believe that the severe somatic disturbances Reich observed in his patients were part of a prolonged pre-Primal state.  When confronted by Reich, the patient's defenses crumbled, but Reich did not connect to the underlying Pain, only to the intense anxiety that often presages the ascension of Primal Pain.  He rightly recognized that "something had happened here that was somehow inherent in the therapeutic process," and that that something was the physical reality of Pain.  It was precisely because the patient's anxiety in this unresolved, pre-Primal state was so severe and hence observable that Reich was able to make that vital connection between mind and body.

Reich now believed he had finally discovered the physical, biological source of human emotions.  He called it "orgone energy" -- a type of energy he thought was distinct from all other known types of energy.  Here Reich's theory turned mystical, for he contended that this orgone energy operated in all forms of life and filled all space.  He even went so far as to develop the orgone accumulator:  a box in which one sits in order to concentrate orgone energy so that one's "energetic charge" is amplified.  Reich later "discovered" that when orgone energy is immobilized in the body due to chronic muscular armoring, it loses its life-enhancing qualities and becomes deadly (Deadly Orgone, or "DOR").  He then devised another device to withdraw the immobilized orgone from the organism.

In my opinion, in this DOR, Reich was really observing the bound energy of Primal Pain.  While bound Primal Pain does not involve any unknown source of energy, it does involve neurological processes only recently discovered.  We now know that bound Primal Pain is indeed deadly to the system.  And while it cannot be syphoned off via a mechanical device, it can be syphoned off via internal, conscious connection to it.  Reich's devices for accumulating and withdrawing orgone energy may seem humorous now; one commentator places Reich's DOR and orgone accumulator in his "wilderness of inflated theory that is reminiscent of the mad astronomer in Johnson's Rasselas who believed he controlled the weather."[4]  They do, however, reflect Reich's important recognition of the very physical and concrete processes underlying neurosis.

Reich's discovery that energy could be bound into the system via muscular tension lead him to clarify his belief in the unity of mind and body.  He concluded that character armor (our psychic defenses) was  "functionally identical" to muscular armor in that they both serve the same function in the psychic apparatus and cannot be separated:

The loosening of the rigid muscular attitudes resulted in peculiar somatic sensations...To comprehend these manifestations, I had to break with all the old concepts of psychosomatic interrelationship.  These manifestations were not the "result," the "causes," or the "accompaniment" of "psychic" processes; they were simply these processes themselves in the somatic sphere.[5]  [Reich's italics]

Here Reich clearly states that psychic defenses do not "cause" muscular armoring, nor do the latter cause the former.  He is saying they are parallel processes, but what he doesn't ask is, parallel processes of what?  If neither psychic nor somatic disturbances cause, or result from, one another, what then causes both of them?  Reich comes close but ultimately falls short.  His theory remains a theory of defenses because he did not perceive the underlying, primary cause of those defenses:  Pain.  Repressed Pain is the one reality, manifesting in a myriad of ways through psychological and physical defenses within the different levels of consciousness.  It produces the energy which keeps muscles tense and prevents relaxation; it also produces neurotic ideas and behaviors.  Pain becomes both the unifying principle and the sine quo non of defense mechanisms.

Even if you could accumulate and remove neurotic energy with some mechanical device, you would still be leaving the Pain intact, still stirring up surface symptoms from its subterranean sphere.

Alexander Lowen and Bioenergetics

Alexander Lowen began his psychological work as a patient and student  of Reich's from 1942 to 1945, and then continued as a Reichian therapist from 1945 to 1953.  His initial work with Reich confirmed for him that the body was the "basis of the personality." Although he felt that his therapy with Reich was helpful for him personally, Lowen later realized that many of his neurotic fears and problems persisted.  By this time, 1957, Reich was dead, found that way in his jail cell, to where the FDA and the courts had hounded him for the "fraud" of treating people in his orgone accumulator.  Lowen began to work with his associate, John Pierrakos, in an effort to resolve his personal problems.  In the course of this work he developed the basic body positions and exercises that are now standard procedures of his therapy: bioenergetics.

While Lowen retained Reich's principles of muscular armoring, character analysis, and the importance of breathing, he departed from Reich's singular emphasis on sexual functioning and orgiastic potency.  Here Lowen defines bioenergetics:

Bioenergetics is a therapeutic technique to help a person get back together with his body and to help him enjoy to the fullest degree possible the life of the body.  This emphasis on the body includes sexuality, which is one of its basic functions.  But it also includes the even more basic functions of breathing, moving, feeling and self-expression...The goal of bioenergetics is to help people regain their primary nature, which is the condition of being free, the state of being graceful and the quality of being beautiful...Bioenergetics aims to help a person open his heart to life and love.  My position is that the energetic processes of the body determine what goes on in the mind just as they determine what goes on in the body.[6]  [Italics added]

Below I will explain how Lowen reversed the mind-body relationship by making effects into causes and causes into effects. Each major part of his theory contains this error of reversal:  his theory of the role of defenses and of anxiety, his notion of the muscular origins of character structure, and his concept of depression and its cure.  Finally, I will show how his theory is really more of a personal metaphor for his own experience than a rigorous scientific investigation of objective processes.

Lowen's Theory of Defense

For Lowen, the heart is the core of therapy, both literally and metaphorically.  He contends that all of our defenses develop in reaction to early disturbances in the heartbeat.  These defenses form layers around the heart.  The outermost layer contains the ego defenses of denial, projection, blaming, distrust, and rationalization (a typical Freudian framework).  Next comes the muscular layer which produces the chronic muscular tensions that support the ego defenses and protect the person against the underlying layer of suppressed feelings.  These suppressed feelings constitute the next layer, the emotional layer, which contains feelings of rage, panic, despair, sadness, and pain.  Finally, there is the core or heart, which contains the ability to love and be loved.

The problem with this schemata is that it is really a product of Lowen's intuition rather than of known research in the field. The brain, which we now know is the controlling organ of repression, is left entirely out of the picture.  In its place is the more poetically-appealing heart.  Unfortunately, the heart is really just one more organ that responds to the signals of catastrophic Pain.  It is the brain, not the heart, that mediates these signals, and it is the brain that contains the memory circuits from which Pain resounds.

Lowen contends that our inability to love as adults comes from the closing of our hearts in childhood.  This might sound like a convincing metaphor, but it is far from the whole process.  Our inability to love as adults results from the active presence of Pain and repression which shut down the entire system.  It is then that love will be blocked from "entering."  For repression not only blocks internal information, it also blocks external input, all to keep us from being overwhelmed.  In some individuals, the heart will be particularly affected; in others, the stomach or the head or the back will take the brunt.  The point is that the central problem in neurosis is not a metaphorically closed heart, or even a literally tight heart, but the fact of reverberating circuits of physical Pain in the limbic system.

Perhaps we do "close our hearts in childhood," but why? Specific traumatic events have this effect, overwhelming traumas which engrave Pain in our memory eventually are mediated by the limbic system, the hypothalamus and thalamus which ultimately mediate heart action.  If the heart is constricted, as in angina, it is often due to Pain.  Again we see the effect (a closed heart) being confused with the cause.

Lowen goes on to explain the importance of working with all the layers.  Here I agree, but only generally, for again Lowen reverses cause and effect:  "If one works directly with layer two (the muscular layer), one can move into the first or third layer whenever necessary.  Thus, working with the muscular tensions, one can help a person understand how his psychological attitude is conditioned by the armoring or rigidity of his body.  And when advisable, one can reach and open up the suppressed feelings by mobilizing the contracted muscles that restrain and block their expression."[7]  [Italics added]

The first problem here is that muscles do not control feelings.  On the contrary, muscles tense in response to unacceptable feelings.  They are an effect of feelings, not a cause, as Lowen would have it.  The second problem stems directly from the first.  The way to resolve those contracted or armored muscles is to contact those specific life experiences that caused the formation of the armoring -- not to work backwards by trying to release feelings in random fashion via an attack on the physical armor.  We know that specific memory circuits are at work innervating the muscles to produce tension.  If the focus is not on those specific memory circuits, the released feelings will be only generalized, symbolized, and disconnected.

In the pre-Primal state of a feeling, a patient can scream or pound a pillow or kick (all techniques used in bioenergetics) but still be left with muscle tension, because no connection has been made with the memory circuit which is the source of the tension. In the final Primal stage, however, the original causative event is connected with the particular muscular tension.  For example, during a Primal, one patient who had had backaches for years screamed, "Get off my back, get off my back!"  He had never before connected the backaches to being weighed down with chores and responsibilities early in his life.  The Primal came about when he was discussing how he always had to take care of his two younger brothers, and every time they got hurt he was blamed.  He never felt the real feeling until therapy -- that, at age 11, he shouldn't have been burdened with carrying for anyone.

Another patient had a characteristic soreness in her shoulders and arms for years.  During a Primal, she felt the source:  "I was always holding back from pounding my mother."  Still another patient felt the source of the pain in his neck he had had for most of his life, pain which usually turned into "tension headaches." His father always told him that he was a pain in the neck.  The very early source, however,  was having his head violently rotated during a difficult birth.  It was the prototypic response to later stress.  When informed that he was a pain in the neck there was already a vulnerability there, a fertile ground, as it were.  It sunk in.

In bioenergetics, the focus is on sensations and generalized feelings rather than on specific, connected events.  "The simplest way to get a person to express feeling," Lowen says, "is to have him kick his legs into the bed and say 'No' in a sustained and loud voice."[8]  The problem with this is that it is too general and too ritualized.  It assumes that all patients need to scream "No" and need to kick their legs.  These types of assumptions greatly limit the possibility for an original and unique expression of feeling. Imitators of Primal Therapy have sometimes operated under similar assumptions, and have encouraged patients to act out imitation primals. Lowen believes that screaming in itself has a powerful cathartic effect on the person, and thus it is used as a standard bioenergetics technique.  He writes:

The scream is like an explosion within the personality that momentarily shatters the rigidity created by chronic muscular tension and undermines the ego defenses of the first layer.  Crying and deep sobs produce a similar effect by softening and melting body rigidities.[9]

Unfortunately, Lowen's view is entirely speculative, metaphoric, and unsupported by research.  We cannot settle for the view that a scream is "like an explosion within the personality," or that crying is for "softening and melting body rigidities."  In our Primal research, we do not assume that all screams or all sobbing has therapeutic effects.  As I have said previously, screaming, crying, sobbing, or whatever is only effective when  it is secondary to the internal connection between the emotion and the original event it expresses.  It is connected feeling, not feeling per se, that resolves neurosis.  In fact, unconnected screaming and sobbing may actually increase bodily tension as it dredges up feelings which stay unresolved.

Lowen's Theory of Anxiety

When discussing the nature of anxiety, Lowen hypothesizes that:

1) all defenses guard the person against anxiety;

2) anxiety arises from a disturbance in the normal functioning of the body, whereas

3) in the absence of defenses, there is no anxiety, only pleasure, so that

4) "we must therefore conclude that it is the presence of defenses that predispose an individual to anxiety, or that create the conditions for anxiety."[10]

He explains that defenses initially develop in response to a hurt or rejection and that their only present-day function is to guard us from an anxiety that we will be hurt again in the future. Although he doesn't differentiate between hurt, rejection, and anxiety, he implies that hurt is past and no longer affects us, while anxiety is future and does affect us.  Lowen also implies that defenses are more a function of projection into the future than repression of past hurt.  And that these defenses not only reflect our anxieties; they prevent us from being spontaneous and restrict us from expressing emotions.  It follows that to dispel anxiety and feel pleasure, we just need to lower the physical defenses.

Lowen's theory of anxiety has several important errors.  The first one is his contention that not past hurt but only the threat of future hurt is what is being defended against.  We know the contrary is true:  defenses operate in response to the immediate threat of repressed Pain, and the only thing it has to do with the future is the threat of Pain breaking into consciousness.  But it is past Pain, not future possibilities, that presents the threat. This brings up the second error:  Lowen's conclusion that defenses are the main problem.  We erect defenses, he says, because we are anxious that we will be hurt again, and therefore the therapeutic solution is to disassemble the defenses.  This will then allow the organism to open to the flow of pleasure.  Our research indicates that the opposite is true.

Defenses, both mental and physical, serve a protective function.  In daily life and in therapy, they guard the person against the ascension of too much Pain.  To remove the defenses as needless and future-oriented is to leave the patient suddenly open to all the repressed Pain in his system.  Lowen again makes an effect into a cause.  Not only does targeting the defenses themselves leave the neurosis intact, it now leaves the patient undefended against it.  The role of defenses in relation to Pain and consciousness must be properly understood before the therapist intervenes in their functioning.

With his addition of the "falling anxiety," Lowen's concept of anxiety becomes a generalized version of his own personal anxiety. A fear of falling, he contends, characterizes all neurotics:

The fear of falling is a transitional state between being hung up and having one's feet solidly on the ground...Every patient who starts to let go of his illusions and tries to get down to the ground will experience some falling anxiety.[11]

The personal side of this is that, as a child, Lowen was terrified of heights, a fear he spent years attempting to dissipate.  He attributes the lessening of his fear to "grounding exercises" he had done with his legs.  But he has taken a fear idiosyncratic to his own life and elaborated it into a theoretical framework.  Furthermore, rather than searching for the deeper causes of his personal fear in his childhood, he takes the easier route of collective identification:  "Every patient who starts to let go...will experience a certain kind of falling anxiety."  In other words, there is no specific historical context for the origin of his or anyone else's anxiety.  Lowen's own terror at being lifted onto his father's shoulders at age eight apparently had nothing specific to do with that little boy or his father, and later could be overcome by grounding his legs through exercises. This he then ritualized into falling exercises for his patients, again dividing them into types of falling anxiety based on their character structures.  The schizoid character, for example, is afraid of falling apart, while the oral character is afraid of falling behind.  The psychopath fears falling down, but the masochist is afraid that the bottom will fall out, and the rigid character fears falling forward.

One problem with these neat designations is that the framework itself overrides the patient.  I wonder whether these fears of falling in certain directions -- be it apart, behind, down, or whatever -- came from actual patient experiences, or do they just serve as theoretical extensions of the character structures.  Did Lowen's patients' fears determine the diagnoses, or did the diagnoses determine the fears?

A more important problem with Lowen's theory of anxiety is that generalities replace specifics, so that the actual cause of each individual's neurosis once again escapes scrutiny.  Not only is it an unsupported abstraction to claim that falling anxiety is curable through grounding exercises; Lowen goes even further out on a limb in theorizing about the so-called origins of falling anxiety:  "It can probably be traced back through our evolutionary history to the time when our forebears lived in trees like some of the apes."[12] This passes down to the human infant as a need to be held securely.  Here Lowen approaches the source, but again as a generality, saying that falling anxiety's "effective cause is the lack of sufficient holding and physical contact with the mother."[13]

I don't think we need to dig into evolution for the secret to what Lowen terms "falling anxiety."  Nor should we assume it is caused by the mother.  Rough handling by the father, with the traditional tossing of the infant up into the air, could be responsible, not to mention a difficult birth where passage through the birth canal was too sudden and violent for the helpless newborn.  In any case, whatever the cause of whatever the anxiety, it is certain that "grounding exercises" in the present cannot undo the traumatic effects of childhood or infant deprivation.  At best, such exercises can remove the patient's symbol of fear -- falling through space, thus forcing the actual source of the fear --"falling" into repressed Pain -- further underground.

Lowen's Theory of Depression

We can learn a lot about Lowen's theory and method from his treatment of depression.  Lowen has written an entire book on depression, in which he explains its etiology and provides exercises for its removal.[14]  He begins with an assumption typical among body therapists:  "The self is fundamentally a bodily phenomenon, and self-expression therefore means the expression of feeling."[15]  Like Perls ("Lose your mind and come to your senses"), Lowen begins from an anti-mental position that leaves the mind and brain out of the picture.  Depression becomes the inability to respond, with the "bioenergetics flow" of feelings blocked throughout the body.  This, like much mind-body movement rhetoric, clearly borrows from Oriental philosophy and medicine.  But again, where are the physiological structures that correspond to this flow of feelings?  You might as well say that depression is basically a question of bad vibes.

As for what causes depression, Lowen says that it's always due to the loss of mother love and by the lack of fulfillment of oral needs which cannot be fulfilled in adulthood.  This is not a bad beginning, but he then goes to exhort that:

When a person becomes depressed, it is a clear indication that he has not been standing on his own feet.  It is a sign that he lacks faith in himself.  He has sacrificed his independence for the promise of fulfillment by others.[16]

This is really a milder version of the neurosis-is-a-choice syndrome we've seen in previous therapies.  Perhaps depression, like everything else about neurosis, may signal a "lack of faith" in oneself.  But then what?  Perhaps the neurotic does lack independence, but the question is why this occurs.  If the neurotic sacrifices his independence, it is because his independence was sacrificed along with his childhood needs.  And the only reason he seeks the "promise of fulfillment by others" is because he still needs.

As a signal of repressed Pain, depression is quantifiable indirectly.  We see it in alterations of imipramine binding, for example, or changes in interleukin II.  It is also evident in lowered immune function.  Although not "standing on one's feet" may be a symptom of neurosis or depression, it is certainly not the current-day cause of it.  Nor in my experience is it evident in all neurotics.

Neurosis begins in the brain, with the alteration via repression of all of our internal systems.  To begin with the feet is to begin at the tail end -- indeed, a literal case of standing the therapeutic process on its head!

It is not surprising that, having reversed the picture, Lowen's major bioenergetics technique involves the lower half of the body:  "Getting feelings into the belly...and into the called grounding the individual."[17]  To be grounded, according to Lowen, is to be in touch with reality:  "to have one's feet on the ground."  Many of his exercises involve stressful physical positions aimed at getting feeling into the belly, legs, and feet.  It is getting well by metaphor, concretizing a metaphor so that it appears to contain reality.

With his grounding techniques, Lowen is trying to superimpose a purely physical feeling of reality over a psycho-neurobiological condition (neurosis).  His reasoning is clearly circular.  To be grounded is to be in touch with reality.  And how do you get in touch with reality?  By being grounded.  When the definition of the first and second variables are interchangeable, you have no definition at all -- just a self-fulfilling tautology.

It is true that metaphorical expressions of mental states often do have their origins in actual experiences.  For instance, Lowen's idiom of having one's feet on the ground may have its roots in the contrary situation of being tossed in the air by the father, or beyond that to being held upside down immediately after birth. But instead of trying to implant that grounded feeling through literal enactment of the metaphor, therapy would do much better to uncover the source of the feeling of having one's feet on the ground or being up in the air -- passing through all its representations in consciousness along the way.  Being up in the air may have once been literally and frighteningly true, but it also describes how a state of mind feels.  In uncovering its specific origin, therapy addresses generalized states as well as localized derivatives.

In Primal theory, reality is definable in concrete terms.  It is comprised of the memories encoded within each patient's brain. These memories have already affected and altered the entire system in ways that are measurable.  To "ground" the person from a Primal viewpoint would mean to put one in touch with the entire experience of one's history.  To normalize cellular functioning, as when we change immune cell functioning, should be the real definition of "grounding"...grounding into oneself.

Lowen puts a lot of emphasis on various patterns of chronic muscular tension which crop up in us when we're depressed.  They are thoracic tensions, diaphragmatic tensions, tensions specific to the upper half of the body -- the chest wall, the shoulder girdle, the throat and neck, skull and jaw, not to mention spasticities in the long muscles of the back and legs.  He explains:

A rigid chest wall will reduce sensation in this part of the body, specifically those sensations and feelings associated with the heart.  When the heart is enclosed in a rigid thoracic cage, one's love is not free, it is restrained and confined.[18]

Again, Lowen has it backwards.  It is not a rigid chest wall that reduces sensation and restrains love.  It is Pain that constricts the chest wall.  A rigid thoracic cage is but one of the multitudinous effects o  repressed Pain.  To follow Lowen's logic in a thorough way, one would really have to work on each and every muscle, each and every organ and system, each and every tissue and cell.

Lowen goes on about how muscular rigidities in the shoulder girdle inhibit "reaching out" physically and emotionally, and about how a retracted jaw indicates lack of self-assertion, while a protruded jaw indicates defiance.  This is more upside-down reasoning.

The Pain which was inflicted when the child first reached out can result from many causes.  One patient remembers crawling up on his father's knee and reaching out for his neck.  He was angrily and abruptly pushed away.  He never tried again.

The reason for one's psychophysical paralysis may be the fact that a great part of one's consciousness is responding to a previous situation that still lives inside where reaching out meant abuse, rejection, or neglect.  To extend his arms now would be to open that memory like an old unhealed wound.   Muscles do not act on their own; they are not autonomously responsible for the part they play in neurotic defenses.  The tight muscles restrain the natural impulse, but the command to do so comes from a memory in the brain that constantly reminds, "reaching out is dangerous!"

While the tight muscles are not the cause of the inability to make physical gestures of affection or need, they may be part of the memory loop; the muscles coding part of the memory.  To put "reaching up" in context when the patient is ready and is on the verge of certain feelings becomes liberating.  With repression, there may be a vague remnant impulse to reach out, but the muscles tighten up against it because the reaching out is reaching into Pain.  The person may feel that he is physically incapable of making the gesture, but it really means that he is also emotionally incapacitated.  To work those muscles hard (because they may ache from all the inhibition) can release part of the memory.  But the context is rarely released, and if it is it happens out of sequence and is therefore not curative.

I have treated patients who during Primals of experiences at age five were encouraged to reach out to their parents as that five year-old.  When they can finally do that there is a tremendous release of crying and sobbing; the tears and memories were locked up in those muscles.  They were liberated when the original blocked impulses were finally acted upon.

Lowen also works psychologically, believing that insight into the origins of the tension is necessary if release is to be permanent:  "A person should understand," he writes, "the relation of his body attitudes -- his tension patterns -- to the experiences of his life, especially those of his childhood."[19]  Yet Lowen never goes beyond the perception that current defenses and current tensions are the root of the problem.  He wants the patient to understand how tension relates to life experiences in a general way, but he doesn't understand that tension simply reflects the past; it does not foreshadow the future.  It is a reaction to what has already happened, not a defense against what is to come.  The reason that one's future is sufficiently tangible to alter every muscle and fiber in a person's body is because that future is really an encoded past, retained by repression, and projected again and again in the attempt to complete the experience and release the repression.  The body's reaction to the future is really a reflection of the past.  But by offering insight, Lowen is bifurcating the patient, part head part body, but not a unified entity.  The insights do not emanate out of the body but are something apart. This continues the neurotic split.

In his contentions that the repressive process is under conscious control and that it is mediated by breathing, Lowen continues to err seriously.  Paralleling RET and TA theories on how children choose certain feelings and behavior, he explains how the child learns to repress his memories and suppress his feelings as follows:

In situations where the expression of an impulse would evoke a threat to a child from his environment, the child will consciously try to suppress that impulse.  He can do this by decreasing his motility and limiting his breathing.  By not moving and by holding one's breath, one can cut off desire and feeling.[20]

Here Lowen reveals a lack of knowledge of research contemporary to his work.  Decreased motility and shallow breathing are only the outermost aspects of an internal neurobiological process that is not under conscious control.  Many individuals do not breathe deeply in order to aid in their repression and to keep from dredging up deep feelings.  In fact, in the old days we used deep breathing to do just that: bring up deep feelings.  Unfortunately, there were too often out of sequence and confused the patient. Although Lowen recognizes the reality of unfulfilled needs, he believes that there is nothing we can do about them, beyond attending to the after-affects:

To grieve over the loss of mother love will not restore an adult's bodily functioning... What is important is to rebuild the self, to develop the full functioning of the body, to root oneself into present reality.  What an adult can grieve for is the loss of his full potential as a human being...The unfulfilled child in him (the depressed patient) must be recognized but its demand cannot be satisfied. The emphasis must be on the crippling of his bodily functioning, for that is the reality of his being.[21]

When bodily functioning is externally manipulated, as in bioenergetics, the progression of muscles worked on or breathing exercises performed is determined solely by the therapist. Whatever bodily changes occur as a result of these manipulations are out of context, both physically and emotionally, and must be but temporary.  By contrast, in Primal Therapy, we have discovered, and quantified, the fact that reliving Primal feelings does indeed cause positive and lasting changes in bodily functioning.  Some years ago, we did electromyegraphic studies (electrical activity of the muscles) on the neck and forehead and found that muscle tension was significantly reduced with feeling.  Everything from pulse rate to temperature to brain wave patterns to breast development can be enhanced as Pain is felt and released.  Most importantly, these changes occur organically from within the patient as a result of his ability to descend into his own Pain.  The patient's tempo, his needs, and the degree of his Pain -- and not a set scheme of bodily manipulations -- chart the course.


Rolfing came to popular attention during the 1960s when Ida Rolf began giving sessions at Esalen.  At that time, she called her body manipulation techniques "Structural Integration," but the nickname "Rolfing" took hold and became the technique's official name.  Rolf's original term, however, tells us more about what Rolfing is in practice.  For Rolf, structure is the key element. The structure of our bodies reflects the events of our lives and literally shapes how we feel.  Therefore, by changing this structure, we can also change our feelings.  Rolf writes:

You can change human beings.  You can change their structure, and in changing their structure you are able to change their function. Structure determines function to a very great degree and to a degree which we can utilize. The basic law of Rolfing is that you add structure to the body.  In so doing you are demanding a change in function.  This is the basic reason why Rolfing works as it does.  It is the basic reason why there can be a study of bodies based on structure in the sense that we use the word.  There can be a change of function, a contribution to the health, well-being, wholeness, and functioning of a body through balanced change in structure.  This is the basic consideration that makes all manipulative techniques worthwhile.[22]  [Italics added]

Unfortunately, "demanding a change in function" is precisely what neurotic parents demand of their children.  Neurosis occurs because one's destiny has been shaped -- structured, if you will --from the outside.  Neurosis means being molded, body and mind, into an unnatural state, by others.  It does not help to be remolded into another shape decided upon by someone else.  We can be sure that destiny is not contained in the structure of our bodies, but in our feelings as human beings.  Reshaping and restructuring cannot be enforced from the outside, or it remains just that:  a partial and superficial alteration forced over the individual rather than arising from within.  To cure neurosis, one must not be reshaped yet again; one must have his own destiny handed back to him.  To have a rigid jaw as a result of holding back rage means that one has to feel that rage in all its force, not having the jaw reshaped.

Rolf recognized that what gets us out of shape are the problems, accidents, and traumas of our lives.  As in Lowen's case, she describes how these limit our physical range of responsiveness and movement and distort the very position of our muscles and bones.  The aim of Rolfing is to reverse this process:

It is a ten-hour cycle of work during which a Rolfer uses physical pressure (direct energy) to stretch and guide fascia to a place of easier movement.  The first aim of Rolfing is to bring a part to where it anatomically belongs and there establish a new movement pattern.  Balance is the primary goal of the work.

"To stretch and guide fascia to a place of easier movement," Rolfers use their fingers and knuckles, fists and elbows to work on connective tissues that cover muscles and joints.  Their aim, according to a contemporary practitioner, is to "improve body posture, alignment, and flexibility."  Ten sessions of this not only enables you to "move differently," it also changes your "body image," and no doubt your self-esteem as well.[23] I underwent Rolfing years ago.  It was one of the most painful events of my life.  It did help me relax for a while but I found no lasting change with it, and certainly nothing happened to my self-esteem.

In response to Rolfing's declared aims, I would firstly point out that it is impossible for me to imagine how 10 hours of anything could produce permanent change of any kind.  How can a body which has spent a lifetime getting out of alignment require a mere 10 hours to be permanently realigned?  The implication is that decades of experience can be eradicated in one day.  This does not hold true for any field of healing.  Even in the case of surgery, where a whole part is neatly removed in a few hours, the person requires weeks if not months to fully recuperate.

Secondly, to disembody a defense from its physical location means that the system must find another defense.  The tension is in the body for a reason -- and that reason is to lock up Pain.

What Ida Rolf lacked was the understanding that specific scenes and events cause a specific muscle grouping to be tense. Feelings are literally stored in the fascia and musculature of our bodies.  They are coded in the cells, tissues, and organs of every bodily system.  Posture, gait, and stance are all part of our complex history; they are organically connected to our neural circuitry.  Putting one's finger on a tense arm or leg is putting one's finger on a part, but only a part, of the old feeling itself. It is not just the muscles that bind our feelings.  On the contrary, the brain and the entire nervous system actually initiate the processes that result in the binding.


Being remolded by a Reichian, a bioenergetics therapist, a "Rolfer," or by a reflexologist or deep tissue masseuse for that matter, is to be reshaped into someone else's concept of what you should be.  It is essentially a confrontational approach in which an expert confronts the physical front.  Like with the deprogrammers for those in cults who confront the ideational system, the body armor therapist is dealing with appearances.  It is again a phenotypic therapy, neglecting deep motivations.  In encounter therapy, the expert confronts the personal-social front and tries to direct it.  In the conditioning approaches, he assaults the behavior and determines how it will be changed.  In this sense, the body therapies parallel these other techniques.  All are mechanistic; all try to change feelings and behavioral mechanical by manipulating external factors.  And all neglect sources as primary targets.  They act in opposition to the dialecticians who see that neurosis is generated by basic conflict, and that resolution must involve addressing that conflict.

While it is true that the body therapists are more interested in feelings than the behaviorists and RET adherents are, the problem is that they focus on generalized feelings rather than on particular connections, on effects rather than causes.

The body therapies operate from the mistaken belief that a anatomically-open organism is somehow an emotionally-open one. This neglects the fact that the only way to get truly open is to deal with those conditions and experiences which closed the body down in the first place:  namely, specific repressions.  Repression shuts down the muscles, and Pain begets repression.  Deep-lying trauma must be identified and dealt with as a whole -- not selectively and temporarily by having its energy released via muscle manipulation.

Rearrangement of muscle groups, however well it is carried out, does not connect someone to their basic, unfulfilled childhood needs, the real source of all excess neurotic tension.  Massage therapy certainly helps one feel better for a while.  Yet no one would say that it is curative.  What sometimes happens with these kinds of therapists is the development of a dependency on a therapist who can externally alleviate pain -- temporarily.   In this sense a body restructuring session is akin to the use of drugs or alcohol or even religion to assuage anxiety for a time.  Short-term relief is certainly preferable to unmitigated suffering, but they do nothing about long-term healing.  If parents had touched, caressed, and soothed their child, perhaps the musculature would not be so tense and would not need constant massage, reworking, and other kinds of physical attention.

Of course, it is helpful to "be aware" of tension in a particular part or various parts of the body, and of how one uses one's musculature to close down on feelings.  That is basically moving the defense upward, however.  Being aware of how the body works can give us a mental defense about bodily defense systems.

I am sure that certain bodily manipulations can be helpful in some Primal patients at the proper time.  Perhaps a patient is ready to undergo a particular early experience, but his body is so tied up that it cannot cooperate.  I am thinking of the barrel-chested man, for example, whose feelings are literally encased. Working with the fascia of the chest, shoulders, and neck might well facilitate getting at feelings.  Knowing the location of key muscle systems is as important for the Primal Therapist as is understanding mental defense mechanisms.  Moreover, a physical therapist might work on certain muscle bundles when a patient is ready for such an experience.  It would be in context and not done haphazardly.  Most importantly, the primary goal is connected feeling rather than relaxed muscles.

Although Rolfing, Reichian, and even bioenergetics techniques appear to be methodical, they are actually random in relation to the patient's reality, because someone else is imposing the sequence.  When not done in context, any physical manipulation must be random -- like free association of the body.  With these approaches, there is no way to know what a hunched or stooped shoulder means, or when it should be manipulated in the patient. It could mean: "I'm afraid of showing my breasts because daddy doesn't like girls," or "I don't want to show my chest and be sexual," or any number of things.  The stooped shoulder is part of an historical defense system and will be changed only when a person relives the experiences associated with that central feeling.

An awkward person who feels as though she is an outcast will walk and move in a way that expresses how she feels about herself. If she lacks coordination it is because she is out of touch with her body.  Feelings brings that coordination back.  One could certainly manipulate the fascia of the shoulders and chest and produce erect posture.  But what happens next?  Will the posture hold up?  More importantly, what has happened to the reasons for that poor posture?  They are certainly not in the mind of the body therapist.

In Primal Therapy, the patient, not the therapist, is the expert, because he is the one with the truth, the truth of his engraved past experiences.  The Primal Therapist is trained to follow the patient's cues back to that history.  The therapist can help, support, and guide the patient's descent into Pain, but he cannot make the final, vital connection to it.  Only the patient can.  Unlike all other therapies, permanent cure in Primal Therapy ultimately depends upon what happens inside the patient, not on the therapist's notion of how the patient needs to be made aware and worked on, realigned and reeducated.  In this sense, the patient alone depends upon himself to relieve and resolve his problems.

We have found that when the key Primal feelings are relived, posture straightens itself out.  In short, posture is a memory, too -- it is the reciprocal of the neural circuit.  It is part of one's overall defenses, not an entity unto itself.  Muscles respond to a stored history of Pain.  Releasing that history is what cures, not releasing its results.

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[1]Cited in Susanna Ligabue, "The Somatic Component of the Script in Early Development."  Transactional Analysis Journal, 21(1), 1/91, pp. 21-30.

[2]Ibid., p. 25.

[3]Wilhelm Reich, Selected Writings.  (New York:  Farrar, Straus, and Giroux, 1960), pp. 119-120.

[4]See Rosemary Dinnage's review of Reich's autobiography, Passion of Youth, in New Republic, 9/26/88, pp. 39-41.

[5]Ibid., p. 122.

[6]Alexander Lowen, Bioenergetics.  (New York:  Lowen, McCann and Geogregan, 1972), p. 44.

[7]Ibid., p. 122.

[8]Alexander Lowen, Depression and The Body.  (Baltimore, Maryland:  Pelican Books, 1974), p. 105.

[9]Lowen, Bioenergetics, op. cit., pp. 120-121.

[10]Ibid., p. 128.

[11]Ibid., p. 201.

[12]Lowen, Bioenergetics, op. cit., p. 213.

[13]Ibid., p. 215.

[14]Alexander Lowen, Depression and the Body.  (Baltimore, Maryland: Penguin Books, 1973).

[15]Ibid., p. 27.

[16]Ibid., p. 39.

[17]Ibid., p. 50.

[18]Ibid., p. 59.

[19]Ibid., p. 60.

[20]Ibid., p. 81.

[21]Ibid., p. 137.

[22]Ida Rolf Talks About Rolfing and Physical Reality, Edited by Rosemary Feitis.  (New York:  Harper & Row, 1978), pp. 34-35.

[23]See "Body Work," in Glamour, 1/94.