By Kathrin Stauffer
I wrote this paper in preparation for a workshop I taught at the UKCP Conference ‘About a Body’ last September in Cambridge. It was an enjoyable workshop at a very wonderful conference. The article has been published in the Journal of the Association of Holistic Biodynamic Massage Therapists (JAHBMT) Vol 8 issue 1, Winter 2004/5, p. 7-9.
My starting point is the experience that I live in a world that is a rich and abundant place, and all that I ever need in order to heal and grow is available somewhere. I have always found that, if I couldn’t get something that I needed, in the final analysis that lack was down to my inability to receive what there was for me. So if I do not have all that I need in order to heal and grow, it is because I do not let myself have it, because I cannot receive it. By this I do not want to deny the reality of wounds that can never heal completely. But I do want to say that I have generally carried wounds that could have healed more and quicker than they did, and that I find I tend to underestimate the resources that are available for my growth.
I can have a lot of different reasons for not receiving what is good for me. Before I go into these, I want to map out a bit more the biological territory that receiving happens in.
The biodynamic map
The sort of experience that I am talking about can be thought of as a series of events: I feel that I need or want something, I find the thing I need, reach out for it, receive it, and then feel good for having it. One of the ways of depicting this is in a vasomotoric cycle:
If we look at the biological processes that go with this kind of cycle, we can see that there is a first phase of the cycle which brings with it a ‘charging’ of the body. I start out with the feeling of longing or desire, which I experience as a ‘hole’, or as a contraction in my body. I have an impulse to reach out for whatever can fill that hole. Doing this involves the activation firstly of my senses in order to find what I need, and secondly of my voluntary musculature in a reaching out gesture. I may start to feel more excited at this point, or be more acutely aware of the lack in myself. All these processes are generally mediated by the sympathetic nervous system, the part of my autonomic nervous system that mediates arousal and a turning outwards towards my environment. As I receive the thing I’ve reached out for, I am likely to feel relief, and then satisfaction. My body expands in these more pleasurable feelings. I feel softer inside and relax as I savour the good feeling of having what I need. My senses and muscles relax and my awareness turns more inwards. These processes are mediated by the parasympathetic nervous system, the branch of my autonomic nervous system that mediates relaxation, wellbeing and digestion.
In biodynamic psychotherapy, we believe that the human organism has a natural capacity for receptivity. We see the kind of cycle described above as part of normal self-regulation, as a way in which the organism can do what it needs to do in order to return to equilibrium, in order to heal and grow. From this point of view we could say that as long as this cycle functions normally, we have the ability to recover from whatever happens to us, and to continue our development and growth in life. It is only when this self-regulating ability is compromised that we need help – perhaps therapy – in order to cope with what we have experienced.
So we can say that only people with a dysfunction in this self-regulatory process need therapy. Or, to put it another way, everyone who comes for psychotherapy suffers from a certain amount of dysfunction or pathology in biological self-regulation and specifically from an impaired ability to receive. Psychologically speaking, they all have certain habitual ways of defending against the experience of receiving. This includes of course therapists themselves.
From the biological process we can see that when I first become aware of a need, I will have to imagine what might make this need better. This phase of the cycle therefore involves mental and imaginative activity, and my energy is likely to be more in the upper part of my body and particularly in my head. In the second phase, I will have to reach out for what I need, or ask for it in some way. The activity here is still mostly in the upper part of my body, and in addition I probably have to take a bit of a risk, so I’ll be feeling a bit anxious. This is a typical pattern that goes with a bias towards sympathetic activity.
The point of receiving is the point where the balance tips from sympathetic to parasympathetic at the top of the cycle. Particularly if I have been longing for something for a long time, the experience of receiving it is quite likely to feel like a big shift in my internal milieu as a lot of biological processes switch quickly into their opposites. I am interested in particular in this moment of receiving and in the subsequent ‘downgoing’ phase of the cycle, and find it quite useful to think both of myself and of my clients in terms of what gets in the way of receiving.
At the moment of receiving, my autonomic nervous system switches from one state into its opposite. At this point I may briefly feel quite chaotic inside and just a little bit out of control. In order to receive what I need, I have to be able to let this sudden reversal of my feeling state happen, to surrender to it. Specifically, I need to be able to let my sympathetic arousal be down-regulated. This process can be inhibited for a variety of reasons, the most common probably being that there is something else going on that makes me feel unsafe and therefore in need to stay alert and keep a certain level of sympathetic activity going. This could be something in the here and now, or it could be a memory that cannot be put aside, or a fantasy born out of previous experience. It is particularly difficult if this fantasy or memory is attached to a previous experience of receiving! We can probably say in general that if I cannot allow my sympathetic nervous activity to cease for a bit, then I will not be able to receive anything that makes me feel good. This is also true for states of shock and post-traumatic stress where the whole autonomic nervous system is overwhelmed and normal self-regulation cannot proceed. In this case, the way back to equilibrium is also through a down-regulation of the sympathetic nervous system.
Going further along the cycle, I find myself in the phase of ‘having’ a good experience. It is here that I feel embodiment is critical, because I can only know from my embodied feelings whether what I have received is really good, or whether what I have imagined will fulfil my needs does not actually do that. It is crucial for this feedback to happen. The concomitant increase in parasympathetic activity is necessary in order to bring the sympathetic activity completely back to baseline in a negative feedback loop. In its absence, the wanting / needing continues in an unregulated fashion, and I never have an experience of ‘enough’. So in this ‘having’ phase, there will have to be a downward shift of my energy, a shift more away from thinking and towards bodily feelings. In biodynamic work, we particularly see the peristaltic activity of the digestive tract that goes with parasympathetic activity as an embodiment of integrating. This is because the emotional integration process parallels precisely what the intestines do: break down what has come in, sift through it, take up into the body what we need and so make that ours, and eliminate what we do not need.
Psychologically, I can think of lots of different ways that I can defend against receiving. I could decide that what I need is simply not to be had, so I don’t need to build up any appreciable sympathetic charge. Then I will give up on reaching out in the first place and resign myself to a life of proud independence and poverty. This type of defence occurs if I am stuck right at the bottom left hand side of the cycle. Or I could decide that I don’t want what I am given but something else, and close myself off to what is available to me right now in a sort of temper tantrum that cannot be soothed. This would correspond more to an arrest towards the top of the cycle. Or I may have the experience that receiving something involves being invaded and made to feel disempowered and bad about myself. In other words, I could have an early experience of being given good things invariably mixed with a lot of bad things, things that poison me. This scenario makes it very unsafe to receive anything. It is likely that I will always feel I need more than I can possibly have, and all I receive disappears into a kind of black hole inside me and fails to make me feel good. Or I may simply be so used to longing and feeling in need that my whole identity is founded on that slight contraction and slight bias towards sympathetic activity, and the experience of receiving something good ends up threatening my very sense of myself. These last two scenarios represent being injured right at the top of the cycle, at the point of receiving. If I have a difficulty in the right hand side of the cycle, in feeding back to myself whether something actually makes me feel good, I risk going through life forever imagining the things that will be wonderful, and never actually reality testing these fantasies. Or, even worse, blinding myself to the bad feelings I actually get from receiving a fantasised good.
I want to propose that there is a response to difficulties in receiving that is typical for therapists, and probably people in the ‘helping professions’ in general. This is the tendency to defend against receiving by giving. Giving has certain advantages over receiving: I don’t have to feel needy or empty but can feel rich and full compared to the receiver when I am giving. I can also get some vicarious gratification from the projective identification with the person who is receiving, from imagining how good they must be feeling. And it allows me to stay nicely in control and retain my position of power. So one way of thinking about my own habitual defences is to say that my way of receiving is to give.
If giving is my habitual way of receiving, I of course have an attachment to my clients’ being able to receive what I am giving them. Which, for the reasons outlined above, they will not do a lot of the time.Depending on how great my attachment is to this kind of defence, my construct of myself as the generous and caring giver and my clients as the grateful and happy receivers can well turn into its opposite. Then I am at risk of experiencing myself as endlessly and reluctantly depleting a place in me that is not very abundant to start with, and my clients as a bunch of needy and incurably contrary neurotics who are attached to their own suffering and sucking me dry. At this point, I am well on the road to burnout.
However the therapist’s position of the ‘giver’ is strengthened and, indeed, demanded of us, by the rule that therapists have to attend to their clients’ needs and seek fulfilment of their own needs elsewhere. We all agree that if we use our clients in order to gratify our own needs, we are abusing them and cease to function as therapists. If I try and hold some openness within myself for receiving something from my clients as well as giving to them, I therefore have to go to some extent counter the definition of my profession. This lands me in a real dilemma.
One obvious solution to the dilemma is to sort of cut our losses while we are working as therapists, and focus on our private lives as a source of good feelings. Whilst I would stress the importance of having other outlets for our creativity and other sources of support than our work, I still have misgivings about just how rigidly we can maintain this split, and how long we can do our work with enthusiasm and engagement if we do not allow ourselves to be nurtured to some extent by it.
I believe that as therapists we always have to be aware of this dilemma and always have to attend to our feelings about it. I also believe that the more we can be receptive to what good things there are in the world for us, the less we will risk getting caught up in a pathological intensity of attachment to our clients’ being able to receive what we offer them, and risk burning out. For me, this sometimes may mean maintaining an awareness that my clients are not just impoverished and pathetic worms but fully developed adult humans who have something to offer to the world in general and to me in particular. I think that it is useful for all of us to observe how we defend against receiving, and to see what we can do to attend to our own ability to receive. It is important that we have the kindness and openness towards ourselves that allows us to feel our needs and attend to getting them met.
Lastly, I want to say something about the moments in which I find I can transcend the dilemma. This happens when I can make good contact with a client in the moment of giving/receiving. In those moments, I feel that giving and receiving become part of the same process, and the contact allows a two-way flow between us. These are also the moments in which we step outside our roles as client and therapist and meet as human beings. They can be profoundly transformative moments for both. They are not necessarily moments when I am actually intending to give the client something, or moments when the client is intending to receive something from me. They are often simply moments of good contact on an ‘I-Thou’ level, moments when humanity touches humanity. Biologically, this observation makes sense to me, because contact is a very powerful modulator of the autonomic nervous system and can mediate a very fast shift into being soothed and nurtured.
Sometimes the art of psychotherapy consists in finding the way in which this can happen, right here and now. It means finding the place in my client that is able to receive something good, in the way that I am able to offer it. This is not always the place in the client that most needs it – in fact, it seems to me that that place often is not able to receive anything. It is as though there is only need there, and not enough of a person who can meet my offering, not enough resilience to sustain the contact, for all the perfect attunement that I may be capable of. It also means finding the place in myself that has the openness to allow for a meeting, for receiving as well as for giving. And it means then making space for the process of having the good and letting it become part of us. Because it is at this final phase of the cycle that new experiences can become literally incorporated into who we are and will persist over time.
I would like to thank the colleagues who have given me feedback on the idea and on the manuscript: John Waterston, Jane Frances, Urs Stauffer, Rosie Bell, Claudius Kokott, and Lynne Holmes.