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SOMATICPSYCHODYNAMIC FUNCTIONALITY IN CHARACTERANALYTIC VEGETOTHERAPY

Xavier Serrano Hortelano

(Clinical psychologist, character analysis psychotherapist specialised in human systems, orgontherapist trainer in P.B.C and in Vegetotherapy. Didactic and Director of Spanish School of Reichian Therapy (ES.TE.R.)

  

  

INTRODUCTION

In our clinical practice we constantly observe a relation so close that exists between difficulties or emotional disturbances, and the genesis and development of many diseases.

The stress theory developed by Selye (vs. Carballo, 1984); Laborit’s inhibition of action theory; Varela-Maturana’s system-oriented “cognitive immunology” supported by scientific discoveries as is the discovery of “peptides” (biochemical manifestation of emotions) of C. Pert and his team from Maryland (vs. Capra, 1996 and Janov, 2000); and W. Reich’s theory of orgasm inter allia, have set the biological and empirical fundaments of those clinical psychoanalytical hypotheses and evidences that were defined by F. Navarro as somatic and psychodynamic functionality.

Today’s scientific tendency starts to conceive human structure as a complex net of systems communicating through a circular and permanent interrelation of the nervous system with the endocrine system and immunity system. And at the same time every human system is in permanent interrelation with others of the same kind, with the social system and with the geographic ecological system, which moves us in what F. Capra calls the plot of Life. Nevertheless, it is the human being itself that constantly disarticulates this net separating us more and more form nature’s laws, and as a consequence, paradoxically, human being is getting ill and ecologic systems are getting altered. This paradigmatic conception is defined as “global Ecology” and in its interior coherent therapeutic measures must be developed in order to extenuate the effects from such disequilibria. There is corporal psychotherapy that exists focusing on human structure, and more specifically, the character analysis vegetotherapy, being the latter the axe along which I intend to construct this article as long as my clinical psycho-corporal practice may serve me as a reference.

Vegetotherapy has its theoretical roots in what was defined by W. Reich as “orgonomic functionalism”. And, as F. Capra describes, “it is a philosophical system of great resemblance with the new scientific paradigm, which is by definition ecologic” (Capra, 1996).

W. Reich expresses this systemic interrelation in the course of his works. With “the analysis of the character he found out that in human character structure persists his social origin in a rigid and solidified form. By means of changes in the impulses, social institutions produced a typical character structure and man’s character structure reproduced during a certain period of time correspondent social institutions and ideologies. By means of this formula an answer was given to the question set out by sociology: “how, by means of what functions was social existence transformed into human ideas? Society and character structure thus form a clear and simple relation of reciprocity and interaction” (W. Reich, 1950).

And, with the development of clinical practice, Vegetotherapy (subsequently called orgontherapy) what was tried to recuperate was the vital pulsation, the adequate energetic flow of life (orgon, quite similar to Freud’s concept of libido), whose alteration causes, indeed, interferences in the communication between the three above described complex systems of human structures, forcing the biological rhythm to search for compensation mechanisms that, along sequels are which provoke illnesses. Having in mind that the principal modulator of all three systems, the way it was demonstrated by Pi Suner, is the hypothalamic hypophysis system, and on the other hand, a regulator of emotional system and highly influenced by emotional conflicts, that is, by the consequences of relational dynamics. In brief, we would contend that the entrance of a new human being into the system is mediated by some requirements of social ecologic systems that not always coincide with the instinctive necessities, i.e., biological necessities, where a strong relational conflict is created, which generates a clear stress. Regarding that “whenever stress is mentioned in the process of a disease, a reference is made to an adaptive failure of great emotional resonance.

Study of stress is thus outlined by the limits of research which departs from the hypothesis to find the link between emotion and lesion” (Valdes, 1983).

  

That is why, as Navarro wrote, “Vegetotherapy seeks to recuperate a certain patient’s equilibrium, between other instruments, by suggesting specific muscular interventions (actings) which would provoke neurovegetative emotional reactions capable to restore sane psychoefectiveness, which has been put into conflict ever since the appearance of the individual, into a space (setting) and of a therapeutic relation” (Navarro, 1990).

This is why it is the emotional disturbance that is one of the unchaining tools of this intersystem interference, and it is by means of this emotional cure that we can recuperate this structural communication, the working tools being the neuromuscular actings, the therapeutic relation, the character analytic elaboration, the usage of convergent tools such as the group, and the permanent attention turned to the respiration. The importance of this factor in the genesis of diseases is also an acquisition of W. Reich: “Respiration has an undoubted influence upon these processes. The potential of skin diminishes in the diaphragm area if one inhales deeply and goes up again when one exhales deeply. With the inspiration the diaphragm exerts a pressure upon solar plexus and this pressure disappears with the expiration. When diaphragm goes down due to expiration, the mirthful expansion of the organism is thus blocked and is directed towards anguish.

Thus a new access was opened to physiology of mental diseases whose central function is anguish. Ever since then my attention was centered over respiratory function of neurotic and biopathic patients: inhibition of full respiration and chronical inspirational action of breast showed it was a universal phenomenon of “mental” diseases. I had discovered the basic mechanism of the so-called “biopathies” (functional diseases).” (Reich, 1950).

This therapeutic approach is developed during individual work on sofa, and in general, a system of muscular action in the seven segments of the muscular carcass laid out by W. Reich following a main-brain dynamics searching for coherence with ontogeny laws and with processes that render as a result human maturity and, consequently, its recuperation.

In order to better understand this theoretical approach, I intend to illustrate this article by describing clinical action as to various patients with functional disturbances. To be more specific: cephalic, gastrointestinal ulcer, and Vaginism. These are cases taken out from an important group, which, viewed their characteristics, may better help our didactic exposition.

  

CEPHALEA (three first segments)

In the usage of this concept I refer to strong pains in the cephalic part of the body, which is in general bilateral and sub occipital, although it may also be localised in the frontal region (face) or it may be felt as a bending around all the head. A palpation at the moment when the pain is produced reveals an excessive muscular contraction. These pains are nor associated with any systemic disease such as diabetes, cancer, hypertension…

For specialists like Friedman, Wolf, Martin and the orgonomist A. Nelson “the starting of headache (not counting above mentioned factors) is directly and very often related to a situation of specific stress, and presumably it is the tension and the emotional stress that cause contraction of neck and head’s muscles, and as a result this prolonged contraction produces headache. Emotional factors are of utter importance, and somatisation of anguish in the form of an increase of muscular tension is present in all cases of M.C.H. (Muscular, Contraction, Cranial)” (Nelson, 1974).

Navarro stands the opinion that “clinical manifestations of cephalea are due to an hiperorgonotic blockade where dynamics is as follows: primary fear from the first moments of life determines a loss of tonus leading to vasodilatation, which makes possible vasoconstriction in order to ensure homeostasis, because if vasodilatation were preserved, this would lead to a lethal exit. Cephalea may be a symptom of hysterical conversion, but it may also be an expression of a psychotic nucleus…cephalea and migraine are due to a “locus minoris resitentiae” of the first segment, and this is why they run accompanied by molestation in vision, hearing and in sense of scent. If cephalea is an expression of hostility, as a consequence of generalised fear, migraine is related to a specific kind of fear..The main therapy is carried out by working at the first segment, as soon as fear has been blocked out.” (Navarro, 1988)

  

The first case is that of Ana, a woman aged 35, separated for 3 years and whose son is 6 years old. She has come to search for a consultation because in the office where she works she has started feeling herself oppressed and with a sensation that she has been questioned, that she is being talked badly about, marginalised, and that the others think she is different. She is obsessed by those ideas and starts to sleep very insufficiently, feeling exhausted, and with no forces to take care of her son. There are no traumatic situations in her biography. Normalised sexuality, but since she got separated she has only had some sexual adventures, not quite satisfactory, though, without being able to start a new couple relation. According to D.I.D.E., Initial Differential Structural Diagnostic, (see Serrano, 1990, b), this is a structure of neurotic masochist hysterical character. Lately obsessive dynamics have become aggravated with certain paranoid tendencies accompanied by strong anxiety, lack of satisfaction and sexual stasis and a clear latent depressive situation that has been maintained since her separation from her husband, which she lived through suppressive and contentedly, her husband having left her because of his relationship with another woman. Along with insomnia, other episodes take place of occipital cephaleas together with pains in the neck and back and intensive dysmenorrhoea. During sessions she shows herself anxious, uneasy, with uneven respiration, forced smile, avoiding contact and with manifestations of a victim and alarm. She also shows a vegetative dysfunction with obstruction, sensation of tickling in the articulations and episodes of dyspnoea and hypertension in the ocular, cervical and diaphragm segment. She transmits to me a sensation of strong contention of sadness and rage, but without the risk of depersonalisation.

By her motivation, economic situation and clinical disposability, I apply a focal frame with Brief Character Analytic Psychotherapy (P.B.C.) (Serrano, 1992) over a 6-month period, one session weekly, with good prospects.

In the first sessions recorded by me her separation and emotional status, which have caused cephalea and insomnia, are going up. On the fourth session during verbal investigation on her biography, sexual aspects and relation to relatives, she talked about the absent presence of the father and of the obsession of the mother. Using muscular techniques (actings), she sits with her mouth open, her arms raised, and staring at one point on the ceiling. On the fourth minute she involuntarily starts weeping, arch her eyebrows and frown her forehead. I animate her so that she would abandon this sensation, so that she would get aware that she is being protected, and crying gets intensified and overflowing. At the end she tells me that she could clearly see her father going to make some exercise with her brother and she stayed home because she was too little and she associated that all with her ex-husband’s acting who would rather go out with his friends to going out with her because there had to be someone to stay with their child. Her emotion was sadness. On the following sessions headache increased in duration, periodicalness and intensity. Sadness got stronger, and she became aware of what great pain had been caused by the separation from her husband, and also because she was left blocked and sort of torpid, she could also see how she projected in her job her sensation of vulnerability and torpidity, indeed being her herself the one who was feeling like that. I also saw how she had that sensation during therapy with me. That allowed me to dive into elaboration of those associations by means of the so-called “triangular circulation” (Serrano, 1992).

For several days she was in a work down and she went on recovering herself energetically and emotionally. Little by little she assumed the avoiding of aggressiveness coming from fear, which was totally denied, and which was also due to the superficial role that her masochist component had. On the tenth session in her muscular exercise she installed herself on the sofa, her head and her neck hanging out, her legs folded. Her respiration started to augment involuntarily and she got a stroke of fear. She started to shout. She felt herself lonely and very weak. In the verbal elaboration she started being aware that the others had made her vulnerable so that she would be docile and compliant like at work, and in her relation with her ex-husband too and started to feel rage more clearly. I get her animated so that, laid down on the sofa, she would lift her arms and her arms well stretched, she should beat the mattress and at the same time saying the word “I, I…!” In the beginning she is feeling ridiculous but then she starts to shout out loudly beating the mattress with great force and rage, opening her eyes widely, her respiration loose and temporarily free. At the 7th minute, i.e., at the end of the acting, she tells me that she could clearly feel like she was not going to let herself got at by other people’s opinions, nor by anybody’s judgments, nor by her father’s, nor by her ex-husband’s, nor by her fellow workers and that she was tired of living in fear.

We worked on the same sequences of actings over two more sessions, and then I introduced an acting with looking around the body with a circular movement, eyes well open. This movement, which in the beginning of therapy was painful to her, in the end, proved to be pleasant and relaxing. She recovered her sleep, her headache disappeared and she could once again feel happy, able to work and take care of her son, having started to enjoy her body once again, masturbate and go out with her friends more freely. Treatment terminated within the fixed terms the planned objectives having been completed, and over the posterior 8 month-post-treatment (one session every two months), none of the main symptoms reappeared, but anxiety continued, as she was conscious of her personal limits. When it was a year after it had all begun there was an increase of work, and personal exercise was decided to be resumed with a deep therapy selecting vegetotherapy.

We can see in this case how focused exercise gives result according to the type of structure it is, and that these symptoms are clearly due to a somatic reactivation of her internal stress state and to emotional contention that provoke cephalic tension. Her symptoms came as a consequence of relational conflicts and aggravation of the masochist-compulsive component at the moment of her separation which blocks experience of pain and rage coming for disappointment and lack of love which triggered mechanisms of “inhibition of action” and “muscular carcass”.

Another case is the one of Isabel, 30, researcher in genetic biology. Her demand for therapy comes as a result of a very acute conflict at work with her boss, which blocks her and submerges her into a strong depression. Since teenage she has had strong occipital and frontal headache combining migraines and hemicranias. D.I.D.E. reflects a borderline structure with depressive-psychotic nucleus with masochist-phallic covering. Historic affective relations (with relatives) were very painful, with a strong postnatal stress, absence of mother and a very authoritative and distant father. Fear was in the nucleus and was the basis of a whole system of problems and was accompanied by a very strong ocular and oral hypertension and diaphragm and respiratory hypotension, as a consequence of low level of vital or orgonotic tension. With this diagnosis the symptom appeared to be the peak of an iceberg of a whole nuclear relational conflict situation of impossible solution if done by means of therapeutic focused work, and that was why from the very beginning she was prescribed to take character analytic Vegetotherapy (VC). Cephaleas did not disappear until the second year of work when the first two segments started to soften, increasing the level of energetic charge, and consequently reducing her nuclear and fear. And got reactivated whenever her structure could not bear an emergent conflict. This is why in many cases for the therapist symptoms must be a reference that would help them know how to accommodate the rhythm of therapeutic process as to each person.

  

On the basis of these two examples we can see how a symptom, on many occasions, is reflecting different logics, reflecting different latent codes, which require different treatments, and consequently we could not generalise as to the etiology of a symptom because this is only a reflection of an autopoietic conflict (Maturana, 1990) of its structure.

  

GASTROINTESTINAL ULCER (GIU) (fifth and sixth segments)

This disease, to a higher extent than the previous one, makes part of cultural heritage of our society. It constantly appears in novels, films, TV soaps, and in our everyday conversations. And an antacid pill is something quite common. It is so common as is ontological insecurity, nuclear invalidity, and dependence of relatives, psychosocial stress, and suppressed hatred towards authority with the activation of the action inhibition system such as automatic blockage of abdomen or diaphragm. We are eating ourselves, as Chiozza says.

We know that modern medical studies present the genesis of disease in connection with a bacterium but this does not avoid the affirmation of functional disturbances because what prepares the ground for the development of this bacterium is the neurovegetative and emotional disequilibria already described by W. Reich. Furthermore, cure by means of corporal psychotherapy confirms this hypothesis.

We have to remind that all mechanisms that enhance gastric motility and secretion somehow imply intervention in large regions of vague nerves, local parasympathetic reflexes, and gastric juice is discharged of it.

Without going into details, I would like to remind that Reich wrote on this theme and that I view it to be quite clarifying and up-to-date to adapt his language to the language of our today’s scientific moment.

“Let us consider with attention the co-ordination of these different processes in the organism with our model of thinking. We have already given a definition to what “somatic” means as a sum of physical and chemical processes in the tissues. The “mental” was defined as the sphere of sensations, perceptions and ideas. In the stomach ulcer they function in interaction. Every eruption of hatred increases contraction of stomach walls. No doubt, the processes of ulcer and hatred are mutually dependent, and this is because as soon as the process of ulcer formation starts, it mines the stomach walls and proceeds according to its proper physic-chemical laws. Stomach’s elevated acidity damages stomach walls: stomach walls become less resistant to these influences, etc., until perforation in the wall is produced. We observe functional interaction between stomach acidity and the tissue structure as a field of action of physic-chemical functions, and we now view it as independent for psyche.

If we have to be consequent in the effort to prove this functional method, we have to put ourselves the question: what is the form of the common functional principle of psychical and somatic alterations in the function? We can situate psychical and somatic alterations in solely one reciprocal relation that differs ones from the others, but we cannot connect them directly. The third common principle where both psychical alteration and somatic alteration of “stomach ulcer” have their roots, their common functional principle (CFP) is much more extended and much more profound than the stomach walls tissue structure or suppressed psychical hatred. Both alterations depart from one general contraction of the organism, which means an alteration in the field of bioenergetic function. We do not encounter a single case of local ulcer or especially unconscious hatred that have not been constructed over an already existing armouring or a general anorgony. Armouring does not form a specific base for ulcer or hatred. There are always special functions that are responsible for the fact that general bioenergetic alteration would be expressed exactly on the stomach walls ulcers. And this localisation or specific concentration of biologic alteration in the stomach requires a clear demonstration; it has its roots in a specially developed contraction in the diaphragm segment that accompanies whatever hidden hatred. This is why it is deceitful to study a stomach ulcer apart from the organism in its integrity, as is deceitful forgetting hatred, which has been powerfully suppressed. The common functional principle of all forms of biological armouring and therefore of all somatic and psychic alterations developing from them is clinically proved for an orgonotic pulsation, totally or partially altered.” (Reich, 1950)

Following this line of thinking, for Dew the three main characteristics in the structure of a patient with ulcer are:

the inflicted damage to the natural self-confidence through pregenital and genital sexual frustration – chronic orgasmic impotence;

subjacent sympathicotony – it is emotionally translated into a deep fear of helplessness;

the compensatory aggression secondary or of substitutional contact in the periphery (parasympathicotony)

However, in each gastric neurotic individual or patient with ulcer I have treated, the biophysical characteristic that has most attracted my attention is the accused rigidity of abdomen and diaphragm segments”. (Dew, 1873)

Then it is Navarro that reminds us “In ablactated rats soon more ulcers appear. Traumatic separations facilitate ulcer, and when the subject is feeling in security, it affectively disappears. The need of aid in these patients is reflected in the necessity of satiety, and the need for food is the one of affection…A tension is produced (anxiety of waiting), which is continued (blockage of diaphragm) where the parasympathetic predominates (hypotony of local sympathetic and reactive hypertony of the rest of the sympathetic system), which provokes predisposition to cancer in the stomach…Flagrancies of those patients are physical reactions to a frustration of a very lively feeling of desire of dependency maintaining a façade of independency but with a charge of very contained aggressiveness. They are oral, receptive and aggressive (idem).

Starting from these theoretic references here I present the case of a man, 35, married, 2 children. Architect, sportsman, very active, combining both physical and intellectual tasks with the tasks typical of his profession. It is suggested to provide vegetotherapy “because he would like to reduce his blockages in order to improve his techniques when playing tennis” (sport he does in tournaments). He feels OK in his everyday routine, and the only thing that bothers him is his gastric ulcer, which has accompanied him since his architectural studies. He knows (for having read) that “this is for sure due to diaphragm blockage, which, being linked with respiration is the factor that limits his tennis exercises”. “Athletic body, confident expression, thoracic respiration with strong cervical and pelvic hypertension. A very affective but rigid father and a very obsessive and anxious mother outline his relations with relatives, but he remembers them with tenderness. His father wanted him to study law (he always dedicated himself to politics) and studying architecture supposed a certain affective split with the father. In fact, he left his home to move to study in another town. D.I.D.E. gave as a result a neurotic compulsive-phallic structure. The prospect in this case is favourable by its insight level and its structured character, the symptom being able to turn either to a P.B.C. like in a V.C. being the targets of the latter more extensive and of structural change which is not possible, and it is only logical with P.B.C., as it has already been demonstrated in other written work. Similar cases of focal treatment have restructures vegetative functioning reducing stress level being more able to express emotions. There are cases where this is not possible and the ulcer clearly responds to an oral ambivalence linked with a depressive nucleus and consequently with more primary biopathetic problems. In this case its origin was traced by a reactive somatisation, which, going chronic turned into a configuration of secondary biopathy, its eradication being more complex and typical of profound therapy. If this patient had been treated since earlier age, the symptom would have been much more localised with adequate prospects for focal psycho-corporal character analytic psychotherapy (P.B.C.)

In this case we may partially confirm this analysis because years ago he was submitted to a short dynamic oriented psychotherapy, and if it did him good in certain things, it did not influence at all his U.G.I. But, what is evident and confirmed by Reich is that there is always a clear problem in the plasmatic motility in these cases.

I put forward this example because during the therapy what became quite obvious was the clearness of the relation between the oral factor and the diaphragm one, between the oral stress and the diaphragm anguish with all already described dynamic and vegetative consequences.

Specifically, there was one very meaningful and interesting session: the patient laying on the sofa in a position typical of V.C.: he starts to realise the acting of a “fish” following indications of the therapist (staring at one point on the ceiling and making a movement to the outside of the lips the way fish do or the way it can be observed in mammals in the shape and at the rhythm that would be felt by the patient), and after a few minutes of doing it surprisingly the reflex of vomiting pops up accompanied by pronounced anguish, cold sweating, fear and nausea. I animate him to continue with the experience and show him the bag where he should vomit if necessary. The patient, despite rationality and the sensation he holds everything under control, something habitual for him, is feeling on this occasion shaken and without any defence whatsoever facing such strong anguish which is getting activated just like some magic just after having made that movement. Once intellectual resistance has been defeated, already finalizing the time of the acting, at the 16th minute, and without being able to stop vomiting and with more and more anguish and nausea, the memory comes of his mother who is giving abruptly and forcedly the nursing bottle to his twin brothers who were born when he was 12 years old himself and another scene where there was the same image but where the protagonist was his sister-in-law with her one-year-old son starting to feel a certain rage towards those people. On further sessions, always the same acting, appeared involuntary vomiting (one of our clinical aims is that processes in the organism if they took place, would succeed in function with the patient’s vegetative rhythm although this should take some time) accompanied by strong rage which went up with the acting of fear and the reflex of vomiting, all of it detained by the response of diaphragm hypertension which raised to alarm. It was since that moment on that he became aware that his mother had done the same thing to him too, but resisted against feeling rage towards her because he had always been quite dependent on figures of high affection in their family, both on his parents and, at present, on his wife tending to idealise situations in order not to enter into a conflict. He comprehended the ulcer symptom when he could not confront his father directly, although he continued the studies he was willing to with subsequent permanent stress. And, progressively, over the contact aiming therapy, oral transference was popping out, and afterwards Oedipal where he once again could see the connection between mouth, diaphragm and pelvis, having started to work over fear of authority. Specifically, by acting which included saying “No!” Moving the neck to the right and to the left at the very moment of making it, surged anguish, and the vomiting reflex and by one movement of retraction of pelvis and of anal sphincter. He gradually started being aware of the existential dissatisfaction maintained by his compulsiveness and his sexual stasis because, in reality, he did not allow himself left to the orgasmic experience, he “was good in bed” but he started discovering the difference between that and the feeling of flows accompanied by giving and love without fear. But this was 3 years after the treatment had started with sessions twice a week (each session lasting 1,30 h). Indeed, pains of his ulcer disappeared when cervical-thoracic work came to an end, the fifth and the sixth segment having softened indirectly, however those segments reappearing occasionally when being worked on by means of acting with respiration and the pelvic movement. Having terminated the therapy and several years of posterior training (one session every two to three months) no trouble reappeared, nor has there been any lesion in physiological or radiological examinations.

  

VAGINISM (Seventh segment)

Among the sexual dysfunctions, a less common disturbance provoking much suffering, though, in women who suffer it, is the Vaginism. This disturbance is

characterised as follows: without any physiological cause the vagina of a woman does not dilate when the woman is experiencing episodes of sexual pleasure either during masturbation or during a sexual intercourse with a partner, thus limiting her capacity to experience pleasure being at the same time a risk for giving birth.

On certain occasions we have seen in our clinical team reactive Vaginism in neurotic structures linked with a desire of sexual revenge of masochist type accompanied by a strong tension in the cervical, diaphragm and pelvic segment (third, fifth and seventh) for problems in relation with familial relatives or including for sexual harassments or violations in childhood and adolescence. These cases allow favourable results within a setting of P.B.C.

Nevertheless, more frequent are the cases of Vaginism where this contraction of the smooth vaginal muscles is produced in a nuclear structure of strong sexual fear which ascends to the oral phase and which displaces vagina within what I have called “genitalisation of orality”. In these cases required treatment is V.C.

The following case describes this in brief. A 25 year-old woman, an institute teacher, single, lives with man as a couple for a year. They have sexual relations excluding the vagina. She is suffering because it is both of them who desire to have full relations; they are also planning to marry and to have a child. She has always got Vaginism. She has not had any masturbation practices, and has to apply compresses because she cannot introduce a swab. No gynecological consultation is possible and this is why the specialist himself gives her the advice to do some psychotherapy. D.I.D.E determines a depressive nucleus borderline structure, with a masochist phallic-hysterical cover.

During the process evidence is given of the relationship between mouth and vagina, between fear and mother, her major problem of sexual identity and her Vaginism. The mother used to have hysterical “pool” episodes of punctual memory loss, provocations in public in the field of sexual and is constantly talking of questioning her sisters. She was twice in mental diseases hospitals during her daughters’ (one year of age difference) critical ages and there was a conscious rebound of the mother for social shame and nevertheless a great affective need which was never accepted. There was too a premature weaning due to the pregnancy with the sister. Working with open mouth acting, the arms and the hands open staring at one point on the ceiling she starts to make this contact with the necessity and the rage, with a strong oral ambivalence. With the “fish” acting appears the fear, muscular tetanus which paralyses her mouth, she cannot move it, she cannot approach her mother, nor can she receive any pleasure of anybody. All this is accompanied by vaginal sensations and by strong fear of the therapist with projections of sexual desire. She is considering on how she could negate her mother to be herself, she also regrets because her mother is not as close to her as her father is, and on certain occasions he is too close to her. The ambivalence is very powerful over the whole therapy and she is considering a lot in therapeutic relation. With the acting of biting the towel and furthermore, during the work with the thorax and shouting NO!, she enters a powerful depression with suicidal ideas. Her body image is totally distortional, empty, she feels herself wicked.

With the arms hitting the sofa she allows herself to experience the rage towards her father due to lack of definition, because of his affective absence, and with strong anguish. A relaxation is progressively appearing of vaginal muscles, and about the second year of therapy they have the first masturbation with penetration of the fingers  and sensation of vaginal pleasure. In the meanwhile she splits with the guy and experiences episodes of homosexuality. Only through work with diaphragm pelvis, more specifically, carrying out the acting of respiration simulating “paddling” and with the NO! acting stomping her legs, oral sexuality is getting integrated with genital; a definition of a woman starts to exist and an identity, an approaching to her mother and an acceptation of her body and her capacity for pleasure. She is not her mother and she has capacity to enjoy. She starts a relationship with a man who she gets married to afterwards. Five years after the therapy had started she got a son of natural birth and experiencing no problems at birth herself.

  

CONCLUSIONS

Concluding this exposition, I can affirm that our clinical work is very hard and complex and even disillusioning whenever we encounter people who we cannot render aid to or our work is not efficient with. But we also enjoy satisfaction on many occasions when we see how people recover their well-being, their capacity of pleasure, their joy of life and their capacity of living that joy of life. And we also learn a clear message, which is that all of this might have been avoided if only our social ecologic systems were closer to the Human. Facilitating conscience of this fact is also our responsibility.

  

  

                                                                                    Xavier Serrano, Valencia, December 2002

   

  

 

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