I have written these papers over a period of thirty years. Most of them are part of the dialogue that has gone on both in me and within my field; that is, between mainstream psychotherapy and body-oriented psychotherapy. My writing has always been an important creative outlet for me. My papers are informal in style, many having been given initially as spoken presentations, at a medical center psychotherapy conference and/or a bioergetic conference. Hopefully some of the vignettes will give you a flavor of the qualities I bring to my work as a therapist.

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NOTE: I will use the masculine personal pronoun for simplicity's sake.

Bioenergetics in Search of a Secure Self

This paper, based on my personal experience and more recently available biographical and autobiographical sources, is an attempt to reevaluate classical (Lowenian) bioenergetic analysis via a perspective based on recent research from the attachment paradigm, Specifically, it explores the use of the body, its energy and sexuality as substitutes for a secure relationship with a caregiver.

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Robert Scaer's Neurobiological Model for PTSD and Psychosomatic Illness

This paper reports on Dr. Scaer's pioneering model for specific psychosomatic illnesses. He sees these illnesses both as conditioned by prior (often developmentally early) traumatic experience and as the later pathoneurobiological expression in specific organ systems of kindled, procedural neural circuitry. The inadequate model of mainstream medicine and psychiatry for the same illnesses is clarified. I find that this work adds clinical specificity and substance to the Reichian/bioenergetic understanding of psychosomatic illness.

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Anatomy of Empathy

In this paper I look at both our traditional Bioenergetic model and more recent research as they bear on empathy. I conclude that, even with exciting recent advances, being empathic is still very much a clinical art. I focus on facial expression, gaze behavior, vocal rhythm coordination and body posture as most relevant to our topic. I look at the limits to our knowing, and the extent to which the implicit can and should be made explicit. I also state that a non-linear, dyadic systems view best captures the split second, bidirectional quality of empathic communication. Finally, I touch on the paradox that the very wound which has led us to become therapists, both attunes us to our patients and interferes with our truly being with them. I attempt to illustrate the above issues with several clinical vignettes.

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Projective Identification

This paper is part of my ongoing interest in the differing vocabularies and assumptions to be bridged in the dialogue between a) mainstream verbal and b)body-oriented psychotherapies. I cite recent neuroscience data, clinical research and vignettes which stress the implicit, nonverbal nature of communication. This is illustrated, both in and outside of therapy, by the phenomena of projective identification. In somatic psychotherapy we extend what the psychoanalyst attends to, to include pre-symbolic sounds, bodily sensations and movements.

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An Unquiet Mind

In this book, Kay Redfield Jamison, herself an expert on bipolar disorder, reveals her struggle with this devastating illness that attacks the basic texture of a person's emotions and thoughts. My paper reviews her fascinating story and what it underlines about how much we in psychiatry have to learn about basic mood and emotion. I also submit that Dr. Jamison suffers additionally from an undiagnosed narcissistic personality disorder which further complicates the above issues.

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A Developmental View of Bioenergetic Therapy

This was my first paper. In my training as a child psychiatrist, I was exposed to the early observational studies of Rene Spitz, Donald Winnicott and Louis Sander. This paper attempts to bring to Bioenergetics an understanding of the child's early motor development- it's reaching, grasping, crawling, etc., as important acquisitions on the way towards the fully grounded adult self. I illustrate this integrated approach via three clinical vignettes.

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Cephalic Shock as a Somatic Link to the False Self Personality

Here, in 1983, I continue to explore and elaborate the clinical bridges which can bring unity to the mind-body dichotomy which exists in the field of psychotherapy. I further attempt to clarify the specific pre-verbal problem that draws some patients to a body-oriented therapy, by comparing my clinical construct, cephalic shock, with Winnicott's "mind as the locus of the false self".

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Getting The Head To Really Sit On One's Shoulders

This paper is in some ways the culmination of 10 years of work on deepening my understanding of cephalic shock. In it I detail how in classical Bioenergetics we mistakenly encourage our patients to get out of their heads instead of into them. We do this, I suggest, in violation of Reich's basic principle that, although complex organisms, our total body expands and contracts, like the single cell of the amoeba. The preverbal trauma of the cephalically shocked head and mind within it, must be treated directly so that the same head can once again participate in the basic respiratory pulsation of the entire body.

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Human Trauma

In this and my more recent papers (see Trauma and the Body) I attempt to enrich our Bioenergetic model with the literature and vocabulary of A) Attachment research B) Neurobiological research. In this paper, I was the bioenergetic respondent to Peter Levine's system of therapy, "Somatic Experiencing". I stressed the strengths and weaknesses, as I saw them, of the models of each of our approaches. But two short excerpts are most revealing of the heart of what I believe:

1. I believe that each trauma survivor is a real person and that therefore what is optimal for each such patient is a totally unique mix on a continuum of catharsis and containment. The heart of the matter is his encounter with his inner being and who you, the therapist, really are.
2. There is simply no technique on this planet that overrides what I sense about my therapist's humanity...his ability to tolerate my hatred and brokenness...his ability to be with me in our mutual helplessness. I need to know if he is able to spend as much time with me - not knowing if we will make it - as he spends with the therapeutic approach that makes him comfortable.

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The Psychosomatic Basis of Premature Ego Development

This paper, written in 1976, describes a "no-peace-of-mind" syndrome for which I coined the term "cephalic shock". I outline here a specific developmental process which leaves a person "trapped" in his (I use the masculine pronoun for convenience) head (his cerebral fortress). This is an alternative view from that of Wilhelm Reich as to the problem of a mind that diminishes our vitality, the problem that leads one yearsÊto seek out a bodily, non verbal therapy. These cephalically shocked infants whom I described thirty have, I submit, been more recently identified by attachment research as the disorganized/disoriented subgroup of insecurely attached young children.

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Trauma & the Body

In my more recent papers (see also "Human Trauma") , I have expanded my focus from early preverbaltrauma to include trauma which occurs at any point in the life cycle. Whenever it occurs, trauma, by definition, overwhelms our ability to speak it coherently. Rather, we re-experience it in thenonverbal, sensory-motor language of our bodies. Three clinical vignettes illustrate the above in detail.

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The Trauma Of Cephalic Shock

This was my long-delayed, first published, detailed case study of a patient with cephalic shock. It details how "Ben's" cerebral fortress, his dissociated psyche, responds to my physical warmth and empathic presence. Ben's story demonstrates that cephalic shock is a burden on the head, heart and, inevitably, the sexuality of a person. Deep work on the head end of the organism sets up a resonance in the diaphragm and pelvis. This is then, an unsettling but powerful approach to opening the connection of self to heart and sexuality. But, bigger than any clinical construct, was the heart of the encounter in which Ben and I were touched by each other at a depth that one's hands cannot reach.

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