Authentic movement

[Luke Rickards]

Does this sound familiar?

J Anal Psychol. (javascript:AL_get(this, 'jour', 'J Anal Psychol.');) 1998 Apr;43(2):239-60. Related Articles, (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=9629072) Links (javascript:PopUpMenu2_Set(Menu9629072);) http://www.ncbi.nlm.nih.gov/entrez/query/egifs/http:--www.blackwell-synergy.com-templates-jsp-_synergy-images-synergy_linkout.gif (http://www.ncbi.nlm.nih.gov/entrez/utils/lofref.fcgi?PrId=3046&uid=9629072&db=pubmed&url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0021-8774&date=1998&volume=43&issue=2&spage=239)
The body in analysis: authentic movement and witnessing in analytic practice.

Wyman-McGinty W (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Wyman%2DMcGinty+W%22%5BAuthor%5D).

This paper will describe a form of active imagination called authentic movement, in which attention is given to the somatic unconscious. In authentic movement, patients are encouraged to focus inward and attend to any bodily sensations, images and feelings which may arise. In the process of focusing inward on one's bodily-felt experience, images, somatic memory and the accompanying feelings which arise are then available to be explored as a communication from the patient's unconscious. Authentic movement supports the individual in linking image with affect in that the individual re-experiences the somatic aspect of symbolization. What was previously conserved on the somatic level as unmentalized experience, can now begin to be taken up into the mind, thought about, and made available for analysis. In authentic movement, the analyst acts as a silent witness to the patient's explorations. The quiet focused attention of the witness helps to create a secure containing environment in which the person moving can experience a sense of feeling held and seen. The function of the witness is to hold the patient's experience in his own mind, particularly what is not yet mentalized. The witness utilizes his somatic countertransference, including any images, feelings and bodily responses which are generated by what is being communicated non-verbally, as a means of understanding and responding to the patient's material.

Publication Types:
Case Reports (javascript:AL_get(this, 'ptyp', 'Case Reports');)
PMID: 9629072 [PubMed - indexed for MEDLINE]
From the articleIf the patient is new to this work I ask that they allow themeselves to wait for a sense of being moved from within, instead of trying to produce movement.

[Barrett Dorko]

Luke,

Great stuff. I could never, never discover all of this on my own.

Somewhere long ago I wrote about functioning primarily as a witness. I'll see if I can't find that.

[Diane]

Wow. Any chance you could attach the entire article Luke?

[Luke Rickards]

Here it is Diane.

[Diane]

Wow. Great article.
However, like Barrett, I'm worried that people will actually tell me this stuff if it comes up. Time to refer out if that happens. I feel fairly confident in my abilty to be able to help someone glue themselves together if they collapse in a puddle of tears, the outcome of having trained to be the equivalent of a psychotherapeutic first aid attendent under Peter Levine (training which so far is not included in the PT world, although it should be.. sounds like it might be in Scandanavian countries.. something similar anyway). But no way am I interested in or qualified to sift through any of this unconscious material with someone. Barrett, how do you draw the line? Or is the line just there because you set the boundary and the tone?

[Barrett Dorko]

Diane,

As you say, I set the boundary and the tone. The trick is to make no apologies for this. When I make this clear to the classes many immediately decide that I am some sort of cold and unfeeling person. This is a favorite tactic of the MFR crowd who, as it happens, often view their patient's stories as some sort of soap opera played out just for them.

Decisions about what sort of person I am and what my life is like is the sort of "thin slicing" humans inevitably do and detailed by Gladwell in Blink - The Power of Thinking Without Thinking. I always recommend it.

But I always tell people to read my blog to get a better sense of me personally if they wish. That's why I wrote "On the day that one of Andy's men died" in "The News..." Not, as it turns out, a widely read piece.

[stregapez]

Interesting, but the bulk of what's in that article seems like "psychology stuff" to me, not pt or mt stuff...

As far as I'm concerend, it's better to "err on the side of caution." I've personally experienced a couple instances where medical folks not trained in psch stuff have tried to play psychologist with me, and it was not a productive thing. I've gotten some of that too from untrained New Age people, sometimes with success, sometimes not at all. (then again, ok, I've both experienced and heard of some instances where people trained to do that stuff seemed to be clueless too) If someone is strong and personally well-developed maybe they can distinguish good help from bad help, but the people most likely to need such help are often confused and vulnerable to begin with.

I am very much being confronted with the necessity to set boundaries with a client the last few days. I think it's partly a matter of what one is/isn't trained to do, and partly a matter of what one is comfortable with. Right now, I think I am waiting for the client to develop enough comfort during sessions where me saying "what about talking to a counselor?" is viewed as potentially helpful and not as me just saying "I don't want to deal with/talk to you" or "there is something wrong with you"

I can see where how practices that overlap might possibly be a very good thing if one had the proper training (and personality)

Somehwat unfortunately, I think sometimes people who seriously need somene to talk to about major emotional or life issues are often more willing to see a massage therapist (and make them a sort of counselor) than to see a counselor or psychologist, possibly partly due to stigmas attached to "getting help," especially for men.

I don't mind listening, but i'm not really trained to counsel, and my personality is such that, in all honesty, I enjoy doing it for those people I like, and not so much for those i don't so much.

Dana

[Luke Rickards]

I rarely find the need to frankly set boudaries to emotional expression, as this is usually inherant in the nature and context of the encounter. People usually come to a manual therapist/me because of a perceived relationship between pain and movement (or position), rather than between pain and psychological discomfort. When working with Simple Contact it is this relationship that I explore with patients, and focusing on that seems to avoid any other stuff from becoming prominent. If it doesn't, then it's time to see someone else.


Dana,
Being written by a psychoanalyst, the article does of course focus on psychological aspects, however I think that it is more about the mind-body continuum than psychology alone. The reason I posted it, as you may have become aware of, is that the actual practice of the technique is based on the expression of authentic, ideomotor movements, and as such is very similar to Simple Contact.


Luke

[stregapez]

Luke,

I do realize expectations of pts is somewhat different from mts so far as physical/emotional treatment boundaries. Still, as Barrett mentioned, there are at least some pts group (JBMFR for example, in my opinion) who slide over pretty far into the pysch areas.

I'm guessing too that women may be confronted with the need to set boundaries more often, perhaps partly because women still tend to be viewed more as empathizers, and to be expected to take that role much more often than men.

Dana

[Diane]

I'm guessing too that women may be confronted with the need to set boundaries more often, perhaps partly because women still tend to be viewed more as empathizers, and to be expected to take that role much more often than men. Good point Dana, I agree.

[nari]

I found it mostly unnecessary to set boundaries of emotional expression. The ones who were into telling their stories could do so, and it was generally related to movement dysfunction, pain, fear and loneliness. People seem to like hairdressers for this reason, as well.
Almost all just want someone to listen and for about twenty minutes I think that is fair enough in the PT arena. It's up to the PT to ease the narrative back into relevance with dysfunction, and we should all be able to do that without implying an unwillingness to listen.

One does not have to be a psychologist to assist someone with pain.

Nari

[Jon Newman]

Luke,

I get why you brought this to our attention. Ideomotion is something we all possess, like it or not. It seems the process/environment to express this movement is similar regardless of what someone "does" with the movement. In this case a trained psychoanalyst used it to assist with their psychoanalysis. As a PT, we use it to help a patient move to correct a painful neurodynamic. The psychoanalyst tries to associate what they see with psychoanalytic theory, the PT tries to associate what they see/palpate with changes in the autonomic nervous system, etc.

I was disappointed however by the lack of mention of William James or ideomotion.

[Luke Rickards]

Me too Jon. I have searched for any mention of ideomotion in papers and sites on Authentic Movement therapy and have come up blank so far. Maybe we should let them know.;)

Luke

[Barrett Dorko]

From The Characteristics of Correction (http://www.barrettdorko.com/articles/characte.htm) on my site:

" I've found that the movements that correct us are both active and instinctively driven. Freud said, "The essence of analysis is surprise," and I presume that since the answers to our problems lie in the unconscious, their expression is unexpected. In my experience, the movements we plan don't often help as we had hoped. This would also explain the failure of choreographed regimens or passive movement to relieve pain. If the motion necessary for relief must come from the patient, it is only likely to arise within an environment full of acceptance and faith in their inherent abilities. It is no wonder therapists rarely see it, given the typical environment the profession has created."

We shouldn't be surprised at this connection - the analysts are looking for the answer in the same place we are. Why they've ignored and/or denied the study of ideomotion remains a mystery to me.

[Luke Rickards]

Not all of them have. Check out this on Ideokinesis

http://briandavidphillips.typepad.com/brian/2005/10/index.html
http://briandavidphillips.typepad.com/brian/2005/10/taipei_hypnosis.html

"Those undergoing physical therapy can also use it to improve their movement"

[Luke Rickards]

Barrett,

You are going to love this - http://www.gse.harvard.edu/~t656_web/Spring_2002_students/grinfeld_julie_ideokinesis.htm

[Luke Rickards]

Here is another paper on Authentic Movement that discusses ideokinesis, Feldnekraise, and the ANS.

Luke

[Diane]

I just read through the juicy paper Luke brought above in post #17, and found this:
We move continuously as long as we are alive. We breathe, our hearts beat, our cells divide and replenish. We are always buzzing and vibrating. Babette Rothschild, a body psychotherapist specializing in trauma, asks people to not move for two minutes in her workshops (Rothschild, 2002). People find this incredibly painful. This is what happens in trauma, though. Our bodies that cannot fight or flee will freeze. Many of our clients are traumatized, regardless of the nature of their presenting symptoms. How true. As this relates to persistent pain, if the pain itself is being generated centrally and projected out onto the body, will the part of the brain sensing the pain not feel traumatized as if it were coming from outside? Will there not be stifled movement, even of small bits of "body"? Will the lack of movement (of even small bits of body) not register via sensory input or lack thereof) as a reinforcement of "pain"?
The path to healing must, I am increasingly convinced, include movement. Peter Levine’s work on actual and imaginal movement in the healing of trauma is important (Levine, 1997). Many body psychotherapists use his methodologies to work with trauma, restoring movement patterns and psychological well-being. Movement done in imagination (ideokinesis) has a measurable impact on the neuromuscular system (Sweigard, 1974). Lisbeth Marcher’s Bodynamic System encourages clients to imagine themselves running to safety from early traumatic experiences in order to help facilitate reengagement of neuromuscular patterns and modulation of the fight/flight/freeze response (Picton, 2004). This is deja-vu.. I have met and learned from both Levine and Marcher. I know Barbara Picton.. she's a local PT and one of three fully trained in the Bodynamic system right here in Vancouver. (Gayle, who attended the Nanaimo workshop, is another.) The difference between me and them is that they moved readily into/fully embraced body psychotherapy, and I didn't .. there was still too much belief system to it to attract me long term, and I found I didn't have much interest in exploring others' "material" after all. I have really only ever wanted to be a simple pain buster. (So glad I stumbled into Butler when I did.)

I like (and adopt) Ramachandran's self-description, that in matters of consciousness and neural function he is a "neutral monist." I think "issues in the tissues" simply resolve themselves/ "uncouple" themselves (Levine's term)/ stop being an emotional nuisance once immobile tissues are able to once again move more freely. I expect that authentic movement or ideomotor movement does this from the inside out, and bodywork/work at the skin interface does this from the outside in. I think skin is a two-way highway, that it will (along with all the CNS that it connects to/is integrated with) pick up on, register, collate and consolidate change in a positive direction away from pain at every turn, with every opportunity it has.

[Barrett Dorko]

I am troubled by a couple of things here in the quotes above.

To state explicitly that trauma makes the body "freeze" because it cannot escape simply does not explain the persistent pain seen in many who cannot point to any trauma responsible for their painful onset nor does it explain how people who move all the time continue to hurt. What is needed here is a distinction between the word "movement" as kind of a vague description of individualized flailing (I imagine), often full of drama or someone's idea of grace, and the simple concept of correction which often contains nothing dramatic at all.

Implying that traumatization is present in "many" "regardless of the nature of their presenting symptoms" reveals how little the therapist writing this knows about neuroscience in general and neurobiology in particular. I does reveal some faith in an amnesiac response to trauma I am uncomfortable with.

Implying that trauma is the factor that "freezes" us would lead one to believe that diminished ideomotor expression arises from a fear of pain, which is, in my experience, far less likely than you would think.

The second quote also contains a couple of things I wouldn't say myself. The word "healing" implies that some tissue has lost continuity and this must be resolved. Big problems finding such a thing in many of our patients, and if we did, wouldn't movement retard healing? I am also at odds with the term "ideokinesis" if it in fact means that we should willfully imagine doing something we, I guess, want to do. Why not just do it? This is not to say that the thought of a movement does not elicit muscular activity - James had that figured out in 1895. But, of course, that which is corrective cannot be only imagined if it is to help.

It has to be done.

[nari]

What I noticed was the reference to different parts of the brain as being rather 'separated' - eg the R hemisphere deals with this or that action, emotion, etc. I understand that for most actions or thoughts the 'division' is false; both hemispheres are involved in their various areas.

I agree with Barrett that the article does not entertain the reasons why some people move frequently and still have pain; and others who are 'logs' have no pain. I've met lots of lazy 'logs' with what is termed 'bad posture' and they are painfree. Although movement is extremely useful as a therapy, there has to be more to it. I suspect it has a lot to do with a peaceful existence.

Nari

[bernard]

Hi,

The problem comes because we are unable to see/explain how they move neither they stay immobile.
We are just seeing the visible part of an iceberg. Sometimes this immobility continues to crush things and sometimes a visible motion has the same consequences and some other times it doesn't.

[Luke Rickards]

Barrett,

I agree with you (not to mention other troubling phrases like "free flowing energy"), however I assume that when the author says "Many of our clients", being a psychotherapist, she is not talking about exactly the same kinds of presentations that we are.

Anyway, I mainly posted this because it is the first published, peer-reviewed paper I have found that mentions a relationship between ideomotor expresssion and change in sympathetic tone.

[nari]

David Butler once said that psychologists are our closest colleagues and we need to learn more about each other's work. I rather like that idea; even if such a symbiosis simply encourages PTs in general to understand better the person/patient in front of us.

Can we gather useful information from the nuances of conversation or verbal/facial expression in order to understand their needs/goals better? Until the concept of ideomotion takes hold around the world, this is the next option.

That's what I think, anyway, and Barrett, I know you do not agree with the psychology aspect....;)

Nari

[Barrett Dorko]

Nari,

On the contrary, I agree with what you've said. It isn't learning about what psychologists know that I object to at all - it's abusing patients with a little knowledge that troubles me.

We are commonly bound to manipulate others with voices and movement that are not authentic in the least but simply designed to deceive them so that we might obtain control or money. Waitresses do this. It is the use of communicative principles rooted in psychology and I'm glad to know about them. But to what degree should we do this? When does "being nice" become "being charming"? When does the way we feel take a back seat to our greed for approval or money? These are questions I ask myself every day, especially when in the presence of therapists thinking and practicing in ways I disapprove of. I've found that many of my colleagues respond to outrageous statements regarding theory with silence, choosing not to speak up. I do speak up as calmly as I am able, and I'm not immune to the pangs of doubt that the disapproval of others may bring about.

But to me, there's not much health of any sort in inauthenticity and whatever trouble it will tend to avoid simply builds until control is completely lost. I recall in the various threads here in which Walt Fritz participated there was a distinct effort by him to express his admiration for me and I got a couple private messages from him as well claiming the same. I doubted he actually meant this and just waited. In the end he exploded, his charming manner entirely wiped out in a sarcastic, name-calling tirade.

There's a level of psychological involvement we all must delve into with our patients. Finding the one that resonates with your individual ability and personality varient (shallow for me and deeper for others) and the patient's needs isn't an easy task and it's certainly one we should think about regularly.

In the end, I admire the skills and patience of the psychologist/counselor whatever form they might take in medicine or ministry. This respect for their skills simply reminds me of how powerful that sort of knowledge can be. I use it as I must, and always with great care.

[Nick]

Barrett,

Great post! My respect for you and your work grows daily (is that nice or charming?), even as I struggle to find my own way with what you have taught me. This space that you provide for those who choose to learn what you have to teach is probably the most valuable thing I have taken from your course - even though I did not think so at the time. I think everyone wants to reduce uncertainty. You send people (your students and, I suspect, your patients) into the uncertainty, but equip them with enough knowledge and trust to find their way through. Boundaries are an important part of surviving this intact.

"There's a level of psychological involvement we all must delve into with our patients. Finding the one that resonates with your individual ability and personality varient (shallow for me and deeper for others) and the patient's needs isn't an easy task and it's certainly one we should think about regularly."
This is a profound statement and one that deserves much more study and exploration. The only thing that drives me more crazy then people who think the brain is only the realm of psychologists and physiotherapists should only deal with the body, are therapists who think that over-the-top emotional expression is the path out of pain. Barrett, I think your ability in this realm may be much deeper than you think.

Nick

[Diane]

I agree with Nick: Great post! Barrett, your post is the clearest most concise statement yet about the choice you made and continue to make in your work, your understanding of/resistence to/ balancing act within wider culture.

[nari]

Finding the one which resonates with your individual ability and personality variant...and the patient's needs...

I think this is crucial. Maybe some PTs overestimate their ability and become pseudopsychs; yet others do not recognise or nurture their own innate ability to get to the nittygritty of a troublesome presentation in the clinic.

We all manipulate others in some way, be it either subtle or outright devious.
Often it is not intended to be malicious or scheming; it is simply to ease someone else into one's own way of thinking. I have heard countless PTs manipulating others (including their own patients), but do it in such a way that the 'others' enjoy the trip even if not the arrival.

Barrett, you are far more honest than most. The problem is that others who are less honest find this threatening to their layers.

Nari

[BB]

I am very glad that this topic is being discussed because the inevitable role of emotion in pain and function (normal and abnormal) often makes me question my role.

I wonder if it is similar to differential diagnosis, as has been discussed in some of the direct access threads. It's not that we need to or should diagnose pathology, but we should understand physiology to be able to recognise certain aspects needing clarification or altering our approach.

Similarly with psych issues, we are not qualified to diagnose, and are not qualified to treat problems like depression and multiple personality disorder, etc. But, as was said above by the others, being knowledgeable is a different story.

Here is an example of how I think this distinction can be seen.
The book "Learned Optimism" by Martin Seligman is about the authors research and thoughts on learned helplessness. His findings indicate that those who demonstrate learned helplessness tend to explain things
1) negatively
2) pervasively (I did this wrong, I do everything wrong)
3) Personally (my fault)
4) Permanently (I'll always stink)
Now, having this knowledge does not give me permission to start asking people about past emotions and tell them that they are depressed, but it does help me to see how they explain, and therefore what values they place on certain situations. As we are concerned with the value of "threat" we can look for this type of language and bring to the awareness of the individual, just as we bring it to their attention when they hold thier breath.

We don't have to have them re-experience any past trauma or emotion for this to happen.

Cory

[nari]

Cory

A good compromise.

We often diagnose (because that is what we do in the course of work), but we know the limits. As with psychsocial issues, we are not interested in making a diagnosis; but in knowing that if a patient uses certain types of phrases or words and displays inattention, focuses on one issue and behaves inappropriately within a particular situation (such as talking frequently about her/his miserable home life), we can advise about seeing someone else. But we cannot 'write off' their emotions as if they were not important - it is still important to acknowledge and discuss them in a pertinent way. We can tell them how negative thoughts impact on movement and pain.

Dealing with people means dealing with their emotional state as well as the 'physical' state. It is not difficult to set boundaries on what is beyond our knowledge or role; to avoid emotions altogether seems to defeat our claim on neuroscience-based therapy.

Nari