1. DEFINITION
Bioenergetic Analysis (BA) is a psychotherapeutic method the roots of which go back to Freud, e.g. to psychoanalysis. In contrast to psychoanalysis, however, which focuses mostly on fantasies, thoughts and dreams as the main expressions of the unconscious, BA in addition pays close attention to the bodily expression of the patient as manifested in gestures, mimics, voice and breathing patterns. Rather than splitting body, mind and soul BA understands them as an indivisible unity whereby each influences the others and where therapeutic interventions on one modality can have an effect on the others.
BA originally was developed by Wilhelm Reich, student and later associate of Freud and finally an ardent critic of Freud. He introduced the concept of character armouring meaning that certain emotionally traumatic experiences, often stemming from early childhood, can cause a substantial tightening of certain muscular regions and with it a deadening of the affective state as a protection of the soul. "Character analysis", Reich's most famous piece of writing (Reich 1945) thus describes and explains physical and expressive structures in terms of certain neuroses and introduces the reader to a number of body-oriented psychotherapeutic techniques. Two of his students (and patients), John Pierrakos and Alexander Lowen took the ideas of Reich further. While Pierrakos developed a body psychotherapy form known as "Core Energetics", Alexander Lowen developed BA as it is known today.
Bioenergetics actually means dealing with the "energy of life"; somatic, psychic and affective expressions are controlled by a common biological energy-dependent mechanism.
2. ENQUIRY
Alexander Lowen (1958, 1975), basing himself on his own experiences with Wilhelm Reich and by studying his patients very carefully from the point of view of physical structure, appearance and motility, of their limbs, their chest and pelvic region, their breathing pattern, their facial mimics, eye expression and gestures, he concluded that human beings can be divided in five basic personality structures: the schizoid, the oral, the masochistic, the narcissistic and the rigid character. These expressions have their basis in Freud's concept of developmental phases; they were further explained and inquired into by Keleman (1981) and also Johnson (1985), Keleman paying more attention to the anatomy of a person and Johnson trying to reconcile with Freud. Depending when during development certain deficits or traumata occurred, in coping attempts one or the other character feature would emerge, be rehearsed and would find its form also in the physical structure of the person.
BA as psychotherapy would then be to analyse the deficit, trauma or unresolved conflict, find some verbal and physical interaction to bring them out and help the patient find a means to heal. Lowen has described in many vignettes how he goes about; in fact he has also developed what is known as "body reading", whereby he practically can read the character structure of a person by analysing the body structure and muscular tension pattern. His theoretical and practical concepts are all entirely based on personal observations and are in need of scientific proofs. The section on research will show that the bioenergetic community has been actively engaged since a few years to fill this gap.
3. APPLICATIONS
From the above it is clear that BA is a form of body psychotherapy useful for adults suffering from neurotic and psychosomatic disorders. How useful it is for psychotics is unknown at the present time, as we have no publications yet referring to the treatment of these disorders. Also the application of BA to children and their disorders (Ventling 2001) is still in the beginning, but publications begin to appear. From inquiries and research data (for more details see 1.4. on Research) we know that most our adult patients can be classified according to the ICD-10 as belonging to the class F4 e.g. suffering from neurotic disorders, such as phobic and panic disorders, anxieties, compulsive disorders, adjustment problems, depressions with and without psychosomatic complications etc. A smaller fraction suffers from personality and behaviour disorders, and are classified as F6; about the same proportion suffering from affective disorders we can classify as F3. (Gudat 1997; Ventling & Gerhard 2000; Bertschi 2003).
4. THERAPY
Bioenergetic therapy is preceded by intensive work on diagnosis. The present life situation, the personal history of development including prenatal, natal and postnatal period are explored, as well as the medical history, the experiences in relationships and their qualities. Body expression, posture, muscular tension, blockades in different body sections, degree of liveliness and body awareness are carefully observed and - hypothetically - related to the character structure which seems closest to the person. Thus the therapist gets an idea of the client's life topics, his fundamental problems and his characteristic strategies of solution. Even if this idea needs continued re-examination in the course of therapy, it still offers a practical orientation to structure verbal and non-verbal information as well as body signals. These first impressions teach the therapist what to expect from a client in terms of reactions, resistances etc.
Bioenergetic Analysis is a form of psychotherapy where two approaches are combined: the verbal and the bodily approach. Both approaches take part in the therapeutic process.
The verbal approach starts from the client's reports, paying attention not only to the words but also to the emotional nuances and the bodily reactions involved. The focus is then put on the latter kind of communication so that the client becomes clearly aware of it and can better express himself. Verbal interventions and interpretations on the part of the therapist aim at fostering the therapeutic process through an understanding of the current experience of the client in the therapeutic setting and its relation to his past experiences.
The bodily approach first attempts to deepen breathing and to improve body perception and awareness. This can be done choosing from a wide range of exercises in stress positions, in a state of relaxation or in different forms of movement. One aim is to foster the spontaneous emotional expression of the client - or even make it possible again - and lead him to conscious reflection. (Lowen 1980, 1981, Dietrich 2004, Steinmann 2002)
We distinguish between so-called "exercises" and bodily interventions. Lowen (Lowen & Lowen 1979) and several followers (Sollmann 1988; Dietrich & Pechtl 1991) have described physical "exercises" the purpose of which is to gain a better consciousness of one's body and its parts, especially those parts which are tense, but also to feel more alive, as Lowen called it, more vibrant. Some exercises are intended to bring a person more to his feet, to feel the ground, others to help him to feel freer. Ultimately the effect is that the patient is also more sensitive and open to feelings like sadness, anger, fear, despair etc. and dares to show them. These exercises can be offered to a patient during a therapeutic session or as some therapist colleagues do it, they offer exercise classes.
A bodily intervention is different: here we may mirror a certain gesture or facial expression or suggest taking up a stress position or even a cathartic movement, this with the idea to bring out the hidden feeling that we therapists noticed. There exist many case vignettes reporting such interventions (see the books by Lowen) and also a number of complete case histories with explicit details of such interventions (Ventling 2001, 2002).
5. RESEARCH
5.1.Theoretical inquiries: Differentiation and elaboration of basic concepts, their specific applications and possible links to other scientific disciplines
The literature of Wilhelm Reich (e.g. 1933; 1942; 1948; 1961), founding father and predecessor of most contemporary body-psychotherapies, and that of Alexander Lowen (e.g. 1958; 1967; 1975), founder of Bioenergetic Analysis (BA) and initiator of the International Institute of Bioenergetic Analysis (IIBA) provided us with concepts which continuously stimulate reflecting, criticism and further discussions and inquiries into their validity and possibility of practical applications. Thus many members of the IIBA have felt a need or desire to express their views or practical experiences in form of publications. Such publications can be found first of all in journals published by local societies such as the "Forum der Bioenergetischen Analyse" (German Societies), or "Körper und Seele" (Swiss Society) and the equivalents "Le corps et l'analyse" or "Anima e Corpo" (Francophone and Italian Societies respectively). For an international audience we have the following platforms available: the IIBA journal "Bioenergetic Analysis", "Energy and Character", the "USA Body Psychotherapy Journal", not to mention the possibility of publishing in established journals of various psychological or psychiatric societies. To list all would go beyond the scope of this chapter.
Each volume of "Körper und Seele" of the Swiss Society for Bioenergetic Analysis and Therapy (SGBAT) is devoted to a specific theme, one of these volumes defining basic concepts of Bioenergetic Analysis (Ed. Koemeda-Lutz 2002). Here an attempt is made to link BA to current concepts and results of psychological, neurobiological, sociological, linguistic and medical theory and research.
Recent book publications have explored extended realms for specific applications of Bioenergetic Analysis (Ventling 2001; 2002).
Severals authors have tried to connect neurobiological findings to body-psychotherapeutic concepts and techniques (Resneck-Sannes 2003; Klopstech 2004; in press; Lewis 2004; Koemeda-Lutz and Steinmann 2004; Koemeda-Lutz 2004; in press; Ventling 2004). Finally attempts to connect the bioenergetic concept of energy to concepts and models of modern physics have been undertaken by Mahr (1997; 2001), Carle (2002) and Madert (2004).
During the past few years theoretical (elaboration of basic concepts) and clinical inquiries (single case studies - see separate list; development of new techniques, e.g. Lowen & Lowen 1977; Dietrich & Pechtl 1990) were supplemented by quantitative empirical studies.
5.2.Quantitative Research Studies.
5.2.1. Evaluation of the effectiveness of Bioenergetic Analysis
Four studies have been carried out to evaluate the effectiveness of Bioenergetic Analytic Therapy. Three of these studies were retrospective (Gudat 1997; 2002; Ventling and Gerhard 2000; Bertschi et al. 2003), one is prospective (Koemeda-Lutz et al. 2003 a + b). All studies yielded clearly positive results. Presently the Swiss Charta for Psychotherapy (currently comprising 22 institutes teaching psychotherapy and representing different methods) is planning another prospective study, naturalistic in its design for evaluating outpatient psychotherapies in Switzerland, comparing different methods of treatment. Bioenergetic therapists will participate in this study.
In addition to this general question of overall effectiveness of the method, several areas have been investigated in more detail:
5.2.2. Evidence for "Character Styles" - a psychosomatically based model of personality
Quantitative empirical studies have been carried out by Fehr (1998 a; 2000), inquiring into the validity of the bioenergetic theory of character structures. Fehr (1998 b) developed a questionnaire (Bioenergetische Prozessanalyse BPA) in order to assess characterological profiles of patients and how they change during therapy. By factor analytical computations Fehr (2000) explored the interrelatedness between bioenergetic characterological and other well established personality dimensions, namely the Big Five (Goldberg 1990).
5.2.3. Investigating the Validity of "Body Reading" as a Diagnostic Tool
Body reading has been an important diagnostic tool in Bioenergetic Analysis (Lowen 1958; Bäurle 1988; Kurtz & Prestera 1976; Rank 1994; Sollmann 1999). One study was carried out to test whether trained therapists can reliably gain valid information from their patients' bodily appearance. They can (Koemeda-Lutz and Peter 2001; 2002). A second study was designed to derive a screening skid for "Body Reading" from therapists' verbal accounts of what criteria they base their judgments on (Koemeda-Lutz et al. 2003 c).
© European Federation for Bioenergetic Analysis - Psychotherapy, 2005