Integrated muscular work

  Biodynamic muscle work is largely derived from what Boyesen learned from Aadel Bulow-Hansen and Lillemor Johnson, although she also contributed techniques for emptying muscle, and integrating it with tissue and harmonising energy through the different layers of the body, including bone, muscle,  tissue, skin and aura in Energy Distribution. At Chiron, and in body psychotherapy generally- as I will outline in this chapter - there has been a shift in emphasis from breaking down armour, with the technique known as deep draining, to inviting a more differentiated awareness and tonus in the muscle. The various kinds of touch  include stretching, squeezing, twanging, probing, stroking, emptying and holding the muscle. Each technique is part of the massage therapist's dialogue with the client, exploring  responses in the energetic state of the client and their musculature.

Assessment of Muscles

Presence, Tonus, Gesture

There are several aspects to assessing the client’s musculature/motoric ego. In a general psychological way it is important to evaluate how aware they are of themselves,their feelings, of you, of matter of fact reality. Are they energetically coherent, fragmented, flowing, conflicted? What is your impression of their muscularity - are they heavily or lightly muscled, muscles pumped, squeezed, slack, stringy? Notice gesture, are there repeated gestures, a variety, or an absence of gesture? These offer clues to key themes. [1]

 

Energetic quality and breath

In biodynamic massage, technique is usually part diagnosis, part relating, and  part responding to specific physiology and to the client as a whole. In considering the clients' muscles, I am palpating to discover the degree of tonus, and the energetic quality of the muscle.  Is it hyper or hypo? bulky or thin? is it dry and stringy? or full and charged? is it surrounded by lots of tissue, or quite separated out, or glued in? As I probe or hold I am observing the client's breathing, is it shallow? deepening? and other autonomic responses, such as sweating or trembling.

 

Differentiation and sensation

I am also interested in the clients' experience or sense of the muscle. Touch helps heighten awareness, and with muscle, small movements can also increase awareness. By asking questions, I can gather how much the client has a  differentiated sense of their body - can they feel much sensation in the muscle? if I ask them to do a small localized movement, can they isolate specific muscles or do the muscles seem glued together? Are  they aware of particular feelings associated with a muscle or a movement?

 

Deep Draining

Origins  of Deep Draining

Deep draining is based on the psychomotor therapy developed by the physiotherapist Aadel Bulow-Hansen, influenced and supported by Trygve Braatoy. Braatoy was a psychiatrist who trained with Reich, when he came to Norway in 1935, and believed that massage was an important addition to the psychoanalytic approach. The massage focussed on hypertonic muscles, but Bulow-Hansen found that it had no effect unless it was related to the client’s breathing: "Bulow-Hansen's technique was so specific and methodical....and always aimed to release the spontaneous breath...she was constantly watching how the diaphragm worked" (Cl,1) The respiratory release was often accompanied by, or followed by, emotional outbursts, vegetative reactions, and memories of difficult or traumatic events.

As the patient gave up more and more of the bodily armour and their breathing became much freer, the capacity to surrender to spontaneous and involuntary movements increased greatly. Little by little sensations of warmth, of prickling in the skin, and of shuddering movements in the limbs and trunks began to integrate themselves into [...] reflexive movements of the whole body.(Kat, 165)

Classical Deep Draining

Aim   to loosen armour,  to facilitate postural change,  to deepen breathing, to release repressed feelings.

Use to soften character rigidity, to ‘unblock’ a therapeutic process which seems stuck, to liberate energy where it is held back, to disturb the client’s defenses.

Technique shock impulses - squeezing or twanging - are given across the muscle fibres just before the in-breath. Wait for the breath, encourage expression.

Sequence The sequence is highly specific, muscle by muscle, challenge to the control of breathing, moving around the back between the primary respiratory muscles and accessory breathing muscles.  It addresses holding patterns in muscles surrounding the spine, the sacrum and the scapulae. The sequence then continues with a focus on the segments: the legs, arms and chest, head and neck. The sequence can be varied in order to track a process or to focus on grounding or expression.

Theory of deep draining

Muscular tension and respiration are mutually restricting and mutually liberating.The shock impulse causes a ‘mini startle-reflex’, thus giving the body the opportunity to complete its response to a startle pattern which has become chronic - ie. to contract, and then let go fully, perhaps with the accompanying expressive response, a shout, crying, hitting, or kicking. The focus is on deepening breathing, particularly opening the abdominal respiration, since it is the restriction of breathing which enables the individual to hold back their feelings.

At the moment when the massage is beginning to dissolve the ‘dynamically loaded’ muscle tensions [.....] the diaphragm will begin to flutter. sometimes it will appear to ‘labour’, as if ‘making up its mind’ which way to go. Eventually a breath will work its way through, usually in a wave pattern that is new for this client. At other times a big breath will come through all of a suddent, more like a great gasp, and may be followed by shudders down through the entire body. (Equilibrium, 51)

  The theory is that, with each shock impulse, the muscle will contract sharply, and then relax as it recovers, before contracting again but not to the chronically shortened state it was in before. This expansion invites more fluid back into the muscle, making it riper, softer, more alive and sometimes more painful

  The long term effect of loosening the “incrustation”, as Reich described armour, are changes in posture, concomitant with changes in muscle tension, expression of feelings and deeper breathing. Gerda Boyesen comments that she still considers deep draining to be “the most direct approach to effect radical postural changes”. (BTN, 65) It is distinct from other forms of re-structuring through bodywork, such as Rolfing and  Postural Integration, which manipulate and re-organise the connective tissue surrounding the muscles. (See Ida Rolf, Rolfing)

  Deep draining also contrasts with other forms of bodywork in that it actively encourages expression - movement, sound, crying etc. This is integral to this massage which focuses on challenging and melting characterological defences. This technique is only ultimately effective if the feelings and ideas which caused the initial contraction are released and recognised. However, awareness can develop in stages and it is not only the drama of catharsis that signals a shift, but also the client’s experience of subtler movements of energy and a deeper sense of connection to the body.

  Case example: uncovering a deeper vulnerability

Initially I felt frustrated, I didn’t want to do anything. Therapy feels like work - I never make it easy for myself, I said.  ‘Shall we make it easy?’ the therapist joked, as I got on the massage table.  When the therapist started work around my throat, I had images of quicksand. As the massage therapist put her hand under my back I was surprised by how deep she was going. It was painful, but I felt met by it. It seemed to contact my frustration. Tension on the left side seemed to dissolve, and I felt tingling down my body; the right side felt more defended. I became aware of the tightness of my jaw; I felt an animal sense of wanting to bite; I felt how much I held my disapproval and my disdain in the tension of the jaw. Then it changed suddenley. I felt a melting sensation around my mouth, and could imagine being a baby wanting to suck. I felt so open, I felt I could not tolerate the therapist doing the wrong thing now. But she stroked very gently around my face and down my body, heightening and spreading that soft, soft feeling. Afterwards I felt very grateful and peaceful, and wonderfully alive.

The client complained of having to work too hard in therapy. There was a quivering in the throat, especially in the sternocleidomastoid muscle, as she reported seeing images of quicksand. I decided not to pursue her associations to quicksand, which would mean her ‘working’. I started by putting my hand under her back and twanging rapidly up the muscles of the spine, and going deep into the levator scapulae, which was tight with fear. She found it painful but breathed deeply into the process. As I worked on the muscles on the left side of the neck, she described a sense of expansion around the head. The right side, she noted, felt more closed. I felt the change in the energy around the head which she had described, the muscles had become sensitized and softened. I worked gently on the skin level now around the mouth, jaw, chin. The whole area felt so porous, like the energy field around a baby. I stroked the energy down over the chest and into the arms, and down over the hips to the legs. The legs felt rigid and thick, in contrast to the intense vulnerability around the head. She had not worked, nor stayed in the quicksand where her needs would be smothered; instead, she had let me loosen her defences, and allowed herself to open energetically and receive.

The therapeutic challenge of deep draining

Deep draining is by far the most technically demanding massage in the biodynamic repertoire. At Chiron it is no longer taught to students in training for the Biodynamic Massage Certificate, but only to psychotherapy students.  The therapist needs to be able to locate the muscles quickly and to know and understand the sequence. It is important to observe the breathing response and other autonomic signals. But above all they need to be able to ‘hold’ the client with their presence, to know how far they can challenge, and how to respond to the client’s reaction to the massage.

  When Reich developed his technique of pinching or pressing on chronically contracted muscles, he was working as a psychoanalyst and watching closely for inhibited or feigned responses in the context of the relationship with him. One of his significant contributions to psychoanalysis was the understanding of the negative transference, when patients projected on to him feelings or attributes of significant early figures. When working on his patients’ armour he expected and was able to receive the full impact of the patients’ feelings towards him.

  “a special kind of massage during which [there is an] analysis based on expressions of pain .....a technically controlled form of torture.....”(Tot,75)

  At the psychiatric clinic where Gerda Boyesen learned deep draining there was a definitive separation between the massage treatment and the psychiatric sessions, one was carried out by  a physiotherapist, the other by a psychiatrist (there was some communication between them). Although later she trained biodynamic therapist to work with massage and a psychological process, she did not really re-integrate them. In particular she did not acknowledge or address the negative transference, which can be evoked in any massage process, but is easily triggered by deep draining.

 In part this was possible because Boyesen managed to inspire in her clients and students a strong positive identification with the technique and its benefits. The biodynamic approach explicitly sides with the repressed impulses in the body. [2]   Classically, the therapist assumes the (relatively) uncomplicated ‘good parent’ position encouraging ‘healthy’ self-expression and the setting of limits. So the massage therapist is alert to any embryonic expressive movements in the client, and encourages noises or words which help release feelings, giving permission for the client to assert themselves. The therapist invites the client to come out, to expand into the contact.

  I was deep draining her back, and noticed her legs twitching. I invited her to turn over and went and held her feet, giving a bit of resistance. On an impulse I said, "these are your feet, your legs". She started kicking, and shouting, "get off!, get off me". I encouraged her protest, aware that these feelings were probably connected with her history of sexual abuse.

  I believe that the emphasis on vegetative release - the somatic rather than the expressive, ie. sweating, diahorrhea, skin rashes - was Boyesen’s unconscious way of diverting some of the negative charge. Somatisation itself can be a normal part of a process - the ‘healing crisis’ is a phenomena of holistic treatment and psychotherapy - but intense, sustained somatisation is a symptom of an uncontained process. Boyesen comments on deep draining that its “effectiveness was also a contra-indication, since the changes could take place too rapidly. I heard of cases of acute pneumonia and inflammation of other organs, eg. glands, as a result of the treatment [at the Bulow-Hansen Institute]” (BTN, 65) She stopped working with deep draining until she had developed more supportive complementary techniques.

  "The loosening of rigid muscular attitudes produced peculiar body sensations in the patient: involuntary trembling and twitching of the muscles, sensations of hot and cold, itching, the feeling of having pins and needles." (Kat 167f)

  A Change in the climate

Deep draining was developed in a psychiatric hospital, where patients were contained by their psychiatrist and the institution. Reich saw his patients five times a week. Nowadays, when therapists in private practice are getting more borderline clients, the implications of such a powerful technique have to be considered more carefully. In extreme cases, it may push pre-psychotic or borderline clients beyond their capacity to cope, and even for clients with more internal structure, it can be construed as invasive or even abusive. Of course,  all this depends not just on the technique but the therapist's whole stance towards the client and their therapeutic understanding of a process.

  During deep draining the client reported tremendous energy flow up his back, neck, head and arms. He compared himself to a bottle, which was filling up with energy. He said that what I did for him was "huge", that I touched very deep inside him.(OS) 

 When Boyesen came to London in the late 60's, there was a revolutionary atmosphere  - it was a time of breaking down old structures and believing in the healing power of love and peace. The widespread cultural optimism about human potential, the sense of liberation and embracing radical change probably helped contain the cathartic processes which characterised encounter, primal therapy, psychodrama etc. Through the 80's, 90's and now at the beginning of the new millenium, we are more cautious. Bernd Eiden has commented on the shift in the kind of clients who come to Chiron. [3] Clients with borderline and severe narcissistic structures are more common, so are clients with histories of abuse. There has been a considerable advance in understanding shock and trauma in body psychotherapy, and a recognition of the need to develop a more integrated, containing style of work. 

  I was doing some deep draining - there was peristalsis and some deep breaths, but I had the sense of invading her. And I said, "even though I can't see it, I feel as though you're trembling". She said there was a pain shooting up to her head and she had an image of a flashing light. And so I asked her, "how far would you let me go before you said 'stop!'?"

  However, negative transference which is understood and handled appropriately can still work hand in hand with deep draining. Muscle armour develops out of a need to bind anxiety, and so it inevitably re-surfaces as the armour melts. The clash of needs and perceptions in the client can bring into awareness powerful unconscious dynamics, and thus facilitate release and integration. It is the therapist’s fear of their own sadistic impulses which can limit their capacity to hold the client with their strong feelings and to evaluate how far their defences can be challenged. Often the client experiences a mixture of feelings, the original fear which inhibited expression, anger and sadness, plus the fierce desire to own and embody his or her impulses and feelings.

  D eep draining can open a 'can of worms' ........but it can also awaken a deep joy,  a feeling of being at one with the body, and an appreciation of being  in it.

Modified Deep Draining

Aim  to soften armour, to deepen breathing, to enhance awareness of muscles

Use to release and integrate feelings, to strengthen the motoric ego, boundaries, grounding.

Technique fewer shock impulses. Contact with the muscles is firm and deep but not overly provocative. May use stethoscope, and include emptying. Gentler pace.

Sequence  may follow formal sequence or vary, emphasis on containing and grounding.

  Modified deep draining does not press so directly towards  loosening armour and it offers more containment where feelings may be overwhelming. Rather than focussing on provocation, there is more emphasis on integrating the charge as it builds up. The contact with the muscles is firm, and invites the client to feel his or her way of using muscle, for example, how the muscles are supporting or holding back. The therapist uses less shock impulses, and carefully monitors their effect on the system. He or she waits till the muscles relax before going in deeper. Holding, or a few membrane or hypotonic strokes may be included.

  The metaphor of armour for hypertonic muscles can conceal another aspect of muscles, which is the tremendous resonance between muscles in the body. The body is like a stringed instrument. When I teach deep draining, I suggest the image of twanging a guitar string....

  I had a client who loved deep draining, who always wanted more, and would say, 'go deeper, go deeper', but then I realised that he was actually afraid of contact, of stillness, of light touch. As he pulled me in deeper physically, he was running away inside, wanting me to find him, and yet afraid of being found.

  Hypotonus

Hypotonus massage was developed by Lillemor Johnson, who was influenced by Drs Trygve Braatoy and Nic Waal. She criticised the techniques for dissolving muscle armour and pointed out the limitations and failures of focussing exclusively on hypertonic muscles. [4] She pioneered techniques for working with underdeveloped or hypotonic muscles, which related to deficiencies in the individual’s infantile environment. These deficiencies usually relate to lack of support, lack of attention, and/or major losses. They indicate a psychological collapse, which is palpable in the muscle which is flaccid and inelastic. Johnson perceived however that in hypotonic muscle were latent or remote qualities which could be nourished by gentle stimulus and attention to the breath.

Johnson describes a shy client with a closed mouth, crooked smile, and shifting gaze, “the respiration will be even, halting in the expiratory phase, indicating that anxiety is held back in the missing stage of expiration.”

  Aim to nourish underdeveloped muscle, to modify tonus, to encourage expansion through the breath

Use to build resources where there is collapse and resignation,

Technique stretching the muscle on the in-breath, stretching and squeezing tissue, structural stretch of back, legs, arms etc. Can combine with some lifting.

Sequence follows usual biodynamic sequence, may vary according to areas of need

  Hyptonic massage works with subtle and light touch which serves to awaken and energize muscles that have resigned. Johnson drew attention to breaks in the natural breathing rhythm, as a way to pinpoint where expression is blocked. By staying attuned to the client’s breathing wave, the massage therapist can encourage the breath to come into the muscle.

  A s he lay on his back, I lifted the head gently and stretched it with the in-breath. Then I stretched the arm, pulling it gently away from the socket - this time, his breath, when I invited it to extend a little longer, became staccato. I took hold of his  hand, his breathing deepened and quietened. I began to lightly squeeze the slack muscles just underneath his arm - the breath quivered again. He said he was feeling disgust, and turn his head away from me. I asked what other feelings there were. His chest heaved into a sob, he said he was afraid to give in to his sadness.

  Resistance work and movement

Resistance work is not a massage technique, but a bodywork intervention used to help the client connect to a sense of their own impulse. It may be incorporated into a massage in order to give some focus for the emotional/energetic charge building in the client. The massage therapist offers the client something to push against, usually by placing their hand against the client's  foot, hand, shoulder etc. Sometimes this encourages the client who is inhibiting their force to get in touch with the desire to kick or push. For others, it offers an opportunity to express their anger, or the need for a boundary, in a concrete physical way. [5]

 In order to work with the body's spontaneous self-regulating process, the massage therapist needs to catch gestures which may give clues to the clients inner process. An inner sensation may become an impulse. A fist, a turn of the head, a facial expression, a movement of the leg are indications of a feeling coming to the surface.

 "During a massage, if I see any sign of movement trying to emerge in the client, I would always try to encourage it, because my conviction is that this is going to liberate and express much more energy than would result from what I'm going to do with my hands." (Clover Southwell, AGM)

 One major limitation of biodynamic massage is imposed by the table. It is possible to invite the client to sit, or get off the table and move, but it is not always appropriate, and there is a certain clumsiness, the client may need to put some clothes on. Particularly with muscle work, where so much of the dynamic of discovery emerges in spontaneous movement, massage is restricted by the fact that the client is lying down.

Lifting                                       

During passive movement there is a heightened consciousness of muscular tensions around the joints, spatial relations, and feelings, especially if movements are slow and there are periods of stillness. If the client can allow a process of being held and moved, the nervous system can re-organise precisely because it permits all attention to be given to stimuli both internal and external.

 

Definition work

Definition work is developed from the braking techniques taught by Babette Rothschild  in her Somatic Trauma Therapy Course. [6] These techniques have been adapted for use in a massage context at Chiron. Definition work is very focussed and matter of fact, with the client quite active in the process.

 Aim  to build containment - strengthen the ego - by consciously toning the muscle.

Technique  find muscle, palpate, bring clients awareness to it. Give minimum resistance to it - ie. opposing its function eg. for sternocleidomastoid therapist puts hand under chin and asks client to push down.(Alternatively the therapist may invite the client to turn their head, while  a slight resistance to the movement is offered)  It is important to tell client to contract muscle slowly, not to push or force anything, just enough so they can feel it in action. With the client, identify the point at which the muscle is working to just optimum degree - ie. the client has a sense of the function of the muscle and the feelings that it evokes, and feels contained with them.

Sequence there may be a clue about where to start from the client - eg. they can't feel their legs, feel nauseous, or they just have a sense they want to start with the arms, etc. Sometimes it is useful to do the opposing pair of muscles. The guide is the client’s sense of what feels right.

  This massage is designed to heighten body awareness and help reinforce positive choices. It requires the client to actively sense, evaluate and give clear feedback to the therapist.  The therapist has to keep inviting the client to notice whether each movement makes them  feel 'better' or 'worse'. Better usually means feeling more grounded and contained, and feeling the function of the muscle, a sense of control. 'Worse' usually is any symptom such as nausea, dizziness, discomfort. Clients also need to be encouraged not to overdo it, holding a contraction for  twenty seconds may be enough. Less is more.

 In contrast to working with the expression of feelings, definition work is explicitly about containing - but not repressing - impulses by keeping movement small, and fine-tuning the amount of resistance given. This is ego-strengthening for the client in a number of ways: it tones the muscle, it is very specific, the client is explicitly asked to keep self-regulating - how does that feel? do you want to hold this for longer? shall I do the other side? It can be quite experimental - working out where to give minimal resistance - the client can feel which muscles are being used, can explore, make suggestions. There's lots of dialogue and invention. It can be a great relief for the client to discover how effective this is in containing feelings.

 

  Principles of working with muscle

1. In working for expression and release, the therapist needs to distinguish and discrimate between organic movements, and more mechanical gestures, which may be an attempt to please the therapist or a way of warding off spontaneous movements.

 2. Pain is primarily linked with changes in tension in the muscles, and tender muscles are often those in which the tension is changing. Muscle that are stiff, and are not painful at all at the beginning of a massage, often become tender as they soften, a sign that the body and breathing are changing.

  "muscle activity devoid of sensation does not lead to change" March55

 3. The client may go into a very receptive mode, allowing themselves to let go; or there may be a conscious experiencing of their muscle in a new way; or there may be a more explicit process - exploring movement, feelings, memories or images. [7] What is important is that you sense the client is present with you.

  “experience is in the interaction between motor and sensory happenings” B.B. Cohen

 4. Talking can be an avoidance, or a way of integrating a process. Often the client needs to be encouraged to find a language for what is happening, for describing sensation, and connecting it with feeling.

 "The rhythm of focus from inner to outer experience  created a containing space, which held contrasts and graduations of feeling."

Copyright   Roz Carroll, June 2000


[1] 'Body reading' is one aspect of body psychotherapy. In some traditions - such as bioenergetics - it is carried out as part of a formal assessment, with the client being asked to walk around, and stand, relatively unclothed. Though we teach formal body reading as part of the training at Chiron, it is rarely done with clients. It is largely based on Lowen’s descriptions of physical attributes and postures of character structure. The Bodynamic Institute has developed an even more refined model, based on mapping each indivdual muscle.There are multiple ways of evaluating the client in a more spontaneous and organic way.

[2] This is Michael Soth’s argument, which he makes in the context of an overview of the body psychotherapy tradition, particularly its enthusiasm for catharsis. See ‘Working with and from the objectified body’.

[3]   In an article on the history of biodynamic massage, AHBMT Newsletter.

[4] See Lillemor Johnson ‘Muscular Tonus and Integrated Respiration’ in In the Wake of Reich, ed. d. Boadella (London, 1976).

[6] This course is offered as part of the post-certificate training at Chiron, and is developed from the work of Peter Levine, and of the Bodynamic Institute in Denmark.

[7] Describing  the full range of options in detail is beyond the scope of this book. Working with an in-depth process is only appropriate with a massage therapist who is also qualified as a body psychotherapist.

Psychotherapy, Supervision, Consultation and Training

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