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Second EditionWhy Psychoanalysis?Yoga Therapy
by Michael C. Heller
W. W. Norton, 2012
Review by Jack Darach on Jul 16th 2013
Body psychotherapy is, as the name suggests, a form of therapy which is orientated towards the body of the person seeking therapy. Body PsychotherapyHistory Concepts Methods is a rich, expansive textbook for this field. It is full of fine detail; discussion of practice and theory as well as broader overviews and historical contextualization. Though the book has seven substantial parts plus a conclusion it divides roughly into three sections. The first deals with practical, spiritual and philosophical roots of body psychotherapy; the second with both peripheral and classical psychoanalytic influences on it; the third with specific past, present, and future forms of body psychotherapy.
Many contemporary forms of body psychotherapy have developed from Wilhelm Reich, its most famous theorist and practitioner of the last century, and we now have a bewildering array of body psychotherapy styles. Despite its size Heller's work is not exhaustive on this front -- there are forms of body psychotherapy which are merely mentioned, or not mentioned at all. This doesn't feel like a deficiency, not least because the book aims to bring the field into view from first principles rather than from an overview of all the different versions. Another motive to situating body psychotherapy in a tradition stretching back to Yoga may have to do with legitimacy. Heller's agenda is very sotto voce, absent but for the conclusion, but he is concerned by the ways in which clinical psychotherapy is under attack from those who prefer more empirically grounded forms of therapy. But we know that yoga is beneficial, and this body work is incorporated into body psychotherapy: this is the "robust tradition" which justifies its presence and development.
Of course legitimacy is not a main reason for including the likes of Yoga and Tai Chi Chuan. Heller looks at these practices in part I, where much time is devoted to Hath Yoga and the intricacies of Prana. The philosophical basis is described in part II, with chapters on Plato, Descartes, Spinoza, Hume and Kant. The import of the philosophy isn't always immediately apparent, but later on we find that Heller reads the philosophers back into the contemporary approaches. Part III looks at the conception of the human organism that emerges from the early evolutionary biologists. Parts IV, and V, take us through the peripheral and psychoanalytic influences upon body psychotherapy. Part VI starts to look at body psychotherapy proper with Reich and vegetotherapy.
The nonconscious is to some contemporary body psychotherapy what the unconscious was to psychoanalysis. Heller spends part VII describing work on nonconscious behavior and communication from the classic work of Gregory Bateson (1972) to current strands due to Beebee, Downing, Stern and Tronnick. Some parts of this nascent branch of body psychotherapy involve the recording and fine discrimination of body movements, down to a 1/5th of a second. The thought is that through the collection and coding of movements one can, after meeting and recording a new patient, tell if they match prior non-conscious behavioral schema; and so tell something about their present situation which may be clinically useful. Heller is good on the technical difficulties associated with this: billions of bits of data for every one hour session mean that currently there is a paucity of statistical significant conclusions. However, it felt like more needed to be said on the rationale for the research trajectory especially given that, in many cases, the therapist can come to reliable conclusions about the patient's situation without a corpus of data on the minutiae of their bodily movement. Time, and improvements in technology, will tell whether the promise of this route holds out.
The concluding section includes an interesting discussion of the epistemological differences between psychiatry and psychotherapy and the challenges that have developed from this difference. Clinical therapy loses its value in what has become a health "marketplace" which emphasizes forms of intervention deemed more scientific. As Heller notes, the distinction between scientific forms of therapy (i.e., psychiatry) and clinical forms in terms of which is better supported by evidence is both unhelpful and based on misunderstandings; for while psychiatry may have a better evidential base this does not entail that it is scientific: it may not elucidate the "invisible mechanisms that produce the predictable causal chains observed in empirical research". Nor should this imply that psychotherapy has no evidential base. Heller is here, as throughout, even-handed, noting that some of the epistemological challenges psychotherapy faces are due to the weight often given to charismatic figures within it, leading to problems in the way evidence for particular theoretical claims is chosen.
I liked the honesty of another of Heller's concluding remarks, namely that "No one really knows how psychotherapy functions". That, though it may work, no-one really understands the mechanisms by which it does. However, such a claim rather left me wondering about all the preceding chapters on post-Reichian therapy, with their assured theoretical posits. We get combined a proliferation of kinds of therapy along with a lack of understanding into why they work and one wonders why practitioners continue the bifurcation without getting to grips with the underlying mechanics. Heller's answer to this is to note that this just is the way in which psychotherapy develops: through the creation of schools. In a sense, though he would probably not like me co-opting this phrase, body psychotherapy involves a different kind of health marketplace: therapies for to suit all kinds of consumer preference.
Overall, a book rich with information for the body psychotherapy practitioner or student, one which will reward frequent returning to.
© 2013 Jack Darach
Jack Darach is doing research at the intersection of Epistemology, Action theory and Normativity.