Listening to the Body: Pragmatic Case Studies of Body-Centered Psychotherapy

​By  Amelia H. Kaplan and Laurie Schwartz, Rutgers University and New York, NY

ABSTRACT
Body-centered Psychotherapy (BcP) is a developing field of academic investigation. The present research employed the Pragmatic Case Study Method (“PCS Method”) for systematically studying how verbal and somatic interventions are combined in a single therapy in two 12-session cases seen by an experienced BcP therapist. Following the PCS Method, the cases begin with a presentation of the therapist’s theoretical approach, or “guiding conception,” and a description of how it is applied to each client. The data analyzed in each case include videotapes and transcripts of selected therapy sessions; pre- and post-therapy scores on standardized, quantitative measures; a pre- and post-treatment goal-setting interview; and a semi-structured, post-therapy, outcome interview. The results revealed substantial progress and statistically-significant quantitative changes in both clients. Additionally, distinctly different patterns of progress occurred, as the therapist tailored therapy in accordance with the needs of each client.

Body-centered Psychotherapy (BcP), also known as “Body Psychotherapy” and “Somatic Psychology,” is a developing branch of psychology based on the vital connection between psychological symptoms and physiological states. Although many non-BcP therapies attend to bodily experience, what distinguishes BcP as a unique subfield within psychology is the centrality of somatic sensory experience throughout diagnosis, formulation, and treatment (e.g., see such pioneer therapists in the field as Ferenczi, 1953; Kurtz & Prestera, 1976; Lowen, 1958; Reich, 1945). Additionally, physical touch is more often used by BcP therapists, even though many BcP therapists do not use touch or only introduce it tangentially.

The most comprehensive set of references to BcP exist on a CD-ROM Bibliography developed by the European Association of Body Psychotherapy (Young, 2002). There exists extensive literature on the healing power of touch (Field, 2001; Harlow, 1974; Montagu, 1971) and on touch in psychotherapy (Hunter & Struve, 1998; Smith, 1985; Smith, Clance, & Imes, 1998), yet Somatic Psychology has mostly been developed clinically. May (1998) conducted a comprehensive literature search over the previous 30 years and found 23 empirical BcP studies. A brief review of such studies follows.

The first major prospective clinical trial is currently underway in Germany and Switzerland (Koemeda-Lutz et al., 2003). In this study, eight major BcP outpatient clinics are measuring clients to study the effectiveness of BcP under natural conditions. Preliminary results are promising, finding that after six months of BcP treatment (n=78), small to medium effect sizes were reported across all clinical categories.

Ventling and Gerhard (2000) conducted a retrospective study of 319 former patients to study outcome and stability of the efficacy of Bioenergetic therapy with adults in a private practice setting. Drawing from the patients of sixteen certified Bioenergetic therapists, the authors collected data from former patients who had a mean of 91 sessions (modal 26-50 sessions), and who terminated therapy between 6 months and 6 years previously. The responses demonstrated that for 107 (75%) of the patients, Bioenergetic therapy proved effective to very effective and that the results had lasted from at least 6 months to 6 years.

Several studies have investigated the outcome of BcP using case study designs. Bourque (2002) collected pre and post-test data on four chronic pain clients who engaged in eight weekly “Somatics” sessions and found statistically significant decreases in pain and increases in pain-free activities in three of the four subjects. Employing a qualitative analysis of a single case, Bridges (2002) found that Bioenergetic therapy addressed the client’s “somatic defenses against affect” and significantly increased affective expression in a short-term psychodynamic treatment (McCullough et al., 2003a). Finally, also studying a single case, Price (2002) examined the effects of adding an 8-week adjunctive BcP therapy alongside an ongoing verbal psychotherapy for a woman with childhood sexual and physical abuse. The client demonstrated significant improvement on such standardized quantitative measures as the SCL-90-R (also used in the present study) in such areas as depression, anxiety, and obsessive symptoms, as well as decreases in her physical symptoms. In addition, the client qualitatively reported improvement in “feelings of safety, ability to tune in to internal processes, and ability to access emotion.”

A recent meta-analysis of massage therapy (MT) research, drawing from a wide range of sources (psychology, nursing, medicine, and kinesiology), found MT significantly effective for both physiological and psychological outcomes (Moyer, Rounds, & Hannum, 2004). Additionally, reductions in trait anxiety and depression were MT’s largest effects, similar to those found in psychotherapy meta-analyses. The authors speculate that combining massage and psychotherapy may significantly increase effectiveness more than either alone.

The present research builds on previous systematic, empirical studies to help fill the need for many more such investigations in BcP in order to create a solid scientific foundation for the field. Specifically, this investigation includes in-depth, systematic case studies involving qualitative process compared with standardized quantitative measures to examine how BcP integrates the body into psychotherapy, as seen through the work of Laurie Schwartz, M.S, L.M.T. (Licensed Massage Therapist), a widely known BcP practitioner with 25 years of practice in the field. The main questions guiding this study include: What does BcP therapy look like? What themes in BcP therapy are unique or distinguishing? And how does BcP therapy integrate talk and touch in a unified therapy? In addition, by looking at what is distinctive about a BcP approach, this study can begin to contribute to the questions of whether it is effective to combine talk and touch in a single therapy, and if so, what are the mechanisms of change in such a therapy.

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