Bio-Dynamic Massage in depth

Biodynamic massage was developed by a Norwegian physiotherapist and psychologist, Gerda Boyesen. Even amongst the plethora of bodywork approaches that exist today (shiatsu, Feldendrais, polarity), biodynamic massage is fairly unique. Some of its techniques are based on Swedish massage, and it usually involves a massage table, and direct skin to skin contact and manipulation. Nevertheless the word massage is misleading as well. Biodynamic massage is based on an in-depth awareness of the body as an embodiment of a psychological and energetic process.

Biodynamic Massage can be used as a treatment for stress, psychosomatic symptoms, or as an adjuct to psychotherapy. It can also be used by a body psychotherapist as a moduality within the therapeutic relationship.

Biodynamic massage: from physiotherapy to psychotherapy

The way in which we perceive the world and interact with it depends fundamentally on the quality of aliveness of the tissue (Keleman, 34)

Discovering the natural rhythms of breathing, becoming aware of and respecting, the defences against full respiration [is] a different kind of revelation [?] Witnessing this, people come to a new understanding of how their emotional life is lived in their body, and the impossibility to attempting to deceive, deny or disown the body. (Lee, 118)

Gerda Boyesen was trained at the Ulleval Clinic in the technique of psycho-motor (i.e. neuro-muscular) therapy in the 1950?s. She learned from a physiotherapist called , Aadel Bulow-Hansen, who was taught by Trygve Braatoy, a student of Reich?s and a psychiatrist in Norway. Although Gerda Boyesen has emphasised her own independent discoveries in connection with bodywork, Wilhelm Reich was nevertheless indirectly a key figure in the development of her ideas. Reich, influenced by Freud and Ferenczi, was a pioneer in the articulation of a holistic paradigm for psychotherapy. He situated bodily experience within a frame that co-ordinated physiology, mental representation, unconscious communication ? including transference ? and the impact of society on an individual. In particular, he focussed on muscular armour in its function of inhibiting impulses, numbing sensation and binding excitation. The musculature embodied the ego, he concluded and ?every muscular rigidity contains the history and meaning of its origin?. (Reich, 1947, 300) In his psychoanalytic work, he combined interpretation with systematic pressing and squeezing of muscle and with mimicry of and verbal description of the patient?s manner, body language and gesture. He perceived his patient?s bodily structure and their physical symptoms as ?acquired vegetative behaviour?, directly reflecting and enacting their characterological conflicts. (Reich, 1947, 301)

Whilst Bulow-Hansen refined the technique of releasing the patient?s restricted breathing via massage, she was not interested in the process material or the theory (this was taken to the psychiatrist). But Boyesen, who had undergone vegetotherapy (Reichian analysis) with Ola Raknes, had a degree in psychology and a physiotherapy training, was fascinated by the theoretical and clinical implications of what she saw. Although she later combined massage and psychotherapy, as a physiotherapist the exclusive emphasis was on observation of the vegetative (i.e. autonomic) aspects of the patient?s reactions, and how both to stimulate and modify them.

Boyesen broadened Reich?s idea of muscle armour and autonomic imbalances to include all other layers of psychosomatic organisation, including connective tissue, bone, skin, viscera and aura. At every level, she hypothesised, encapsulations occurred, preventing the dynamic flow of feeling/information in order to limit emotional pain: ?Just as the musculature and the viscera have barriers to hold repression intact and prevent spontaneity, so the tissue has an infiltration, a tissue-armour, which desensitises and disturbs normal circulation and homeostasis, physical, mental and spiritual.? (Boyesen, 1980, 70) One of her major contributions to body psychotherapy was to grasp the systemic consequences of sustained repression and deprivation, which she called ?the somatic compromise?. (Boyesen, 1974b) She was sensitive to the layers of hyper and hypotonic muscle, different kinds of tissue disturbance, tension in internal organs and in joints, and variation in skin capacities.

In particular Boyesen focussed on the way that the quality of the connective tissue ? its colour, degree of sensitivity, elasticity, density or looseness, and chemostasis (toxicity) ? was an immediate indicator of both chronic and acute emotional states. Through palpation of tissue she perceived the specific quality of the client?s membrane (tissue) and the nature of the structure/containment if provided. She began to formulate how the vasomotoric (i.e. blood circulation) cycle was related to stages in an emotional cycle. The vasomotoric cycle is an holistic concept: the degree of permeability of tissue, the ?charge? or absence of charge in the fluid are seen as important indicators as to how ripe feelings are for release, expression, assimilation and/or formulation. (Charge is literally manifest as increased colour, warmth and swelling in the tissue) The combination of therapeutic presence and the use of appropriate massage techniques helps the body regulate and assimilate on an autonomic level. This in effect also facilitates transitions in psychological states, whether explored verbally or not.

Feelings are regarded as spontaneous vegetative processes, which may be inhibited for any reason (conscious or unconscious) by muscular contraction (the ?motoric ego?). Boyesen was interested in the relationship between the autonomic nervous system (broadly identified with the id) and. the central nervous system (identified with the ego). The optimal co-operation between the two systems, she proposed, being converted into temporary or chronic opposition where environmental failure did not support recovery from distress. (Boyesen, 1980, 58-60) [i] She suggests that the unresolved internal conflict is maintained as a latent visceral pressure, which when re-stimulated becomes a more urgent experience of psychological (mind) and physiological (body) pressure in the client.

Boyesen?s techniques are directed towards gradually melting visceral, tissue and muscle armour, allowing what has been repressed to re-emerge and be expressed and assimilated. The aim is a steady titration, with the awareness that at any moment the cumulative effects of dissolving tension may lead to a spontaneous emotional abreaction or vegetative reaction (sweating, nausea, startles, a rash etc) (Boyesen, 1980) In contradistinction to psychoanalytic therapy where symptoms may be perceived as acting out, vegetative reactions are seen as a kind of clearing house for completing emotional cycles.

One of Boyesen?s important discoveries was that by listening through a stethoscope to the peristaltic sounds (rumblings in the gut), she could track the body?s unconscious response to touch. Peristalsis is an indicator of parasympathetic activity, and therefore relaxation, which happens when conditions of emotional safety are sufficient. But more than that, peristalsis, she noticed, was affected by the precise location and pressure of touch, and was particularly strong where there were areas of fluid accumulation. She hypothesised that the peristalsis, a sign that the abdominal digestive process was ?open?, actually helped digest the remnants (hormonal-psychological) of stress in the body. The converse, in neurosis, is described as ?abdominal closure?, and is often accompanied by gastrointestinal symptoms and difficulties with processing feelings. She conceived of ?psycho-peristalsis? as an important mechanism for discharging excess pressure/stimulation, akin to but much subtler than Reich?s orgasm reflex. This intestinal function can be nurtured by massage over a period of time, so that it increasingly comes into operation spontaneously, independent of touch. In this way, biodynamic massage can help restore the optimal functioning of the gut and enhance the individual?s capacity for psychological containment and self-regulation. (Boyesen, 1974b)

Working on a wide range of psychiatric patients taught Boyesen how to moderate as well as stimulate dynamic processes in the body. Whereas challenging techniques to undo the diaphragmatic defence against breathing were suitable for some clients, for ?ego weak? clients following the peristalsis (so that internal pressure is consistently modified) was more effective. In addition, she started in her own private practice to combine modalities, and biodynamic psychotherapy became built around the triad of chairs, mattress (for vegetotherapy) and massage table. (See Bernd Eiden?s chapter) In the following case history, I focus particularly on the classical biodynamic approach of ?melting? tissue and visceral armour through gentle work on the connective tissue and psychological holding.?

Extract from ?Biodynamic Massage as Psychotherapy? in Advances in Body Psychotherapy? ed. Staunton (Routledge, 2002)