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MSNBC / MSN Health

When to Fire Your Therapist: Is your relationship with your therapist the right fit?

healthscout news


Returning soldiers struggle to find therapists

Waiting lists grow as military trims payments for mental-health care

June 10, 2007

WASHINGTON - Soldiers returning from war are finding it more difficult to get mental health treatment because military insurance is cutting payments to therapists, on top of already low reimbursement rates and a tangle of red tape.

Wait lists now extend for months to see a military doctor and it can takes weeks to find a private therapist willing to take on members of the military. The challenge appears great in rural areas, where many National Guard and Reserve troops and their families live.

To avoid the hassles of Tricare, the military health insurance program, one frustrated therapist opted to provide an hour of therapy time a week to Iraq and Afghanistan veterans for free. Barbara Romberg, a clinical psychologist in the Washington, D.C., area, has started a group that encourages other therapists to do the same.

“They’re not going to pay me much in terms of my regular rate anyway,” Romberg said. “So I’m actually feeling positive that I’ve given, rather than feeling frustrated for what I’m going through to get payment.”

Joyce Lindsey, 46, of Troutdale, Ore., sought grief counseling after her husband died in Afghanistan last December. The therapist recommended by her physician would not take Tricare. Lindsey eventually found one on a provider list, but the process took two months.

“It was kind of frustrating,” Lindsey said. “I thought, ‘Am I ever going to find someone to take this?”’

Roughly one-third of returning soldiers seek out mental health counseling in their first year home. They are among the 9.1 million people covered by Tricare, a number that grew by more than 1 million since 2001.

Fragmented, inadequate benefits
Tricare’s psychological health benefit is “hindered by fragmented rules and policies, inadequate oversight and insufficient reimbursement,” the
Defense Department’s mental health task force said last month after reviewing the military’s psychological care system.

The Tricare office that serves Fort Campbell, Ky., and Fort Bragg, N.C. — Army posts with heavy war deployments — told task force members that it routinely fields complaints about the difficulty in locating mental health specialists who accept Tricare.

“Unfortunately, in some of our communities ... we are maxed out on the available providers,” said Lois Krysa, the office’s quality manager. “In other areas, the providers just are not willing to sign up to take Tricare assignment, and that is a problem.”


Tricare’s reimbursement rate is tied to Medicare’s, which pays less than civilian employer insurance. The rate for mental health care services fell by 6.4 percent this year as part of an adjustment in reimbursements to certain specialties.

Since 2004, Tricare has sped up payments to encourage more doctors to participate, said Austin Camacho, a Tricare spokesman. In some locations, such as Idaho and Alaska, the Defense Department has also raised rates to attract physicians, he said.

“We are working hard to overcome those challenges,” Camacho said.

Jack Wagoner is a retired military officer and psychologist and psychiatrist in private practice who also works for a Tricare contractor. He told defense mental health board members last December that in general, Tricare pays “considerably lower” than private health insurance plans.

According to data from Tricare’s Medical Benefits and Reimbursement System office, Tricare pays mental health providers as much or more than a corporate plan would pay a therapist for treating a patient — although in some cases it is lower.

There are different coverage plans within Tricare, and the amount paid to providers varies by plan, location, specialty and services performed.

Psychologists who treat active duty troops are paid 66 percent of what Tricare views as the customary rate. So a psychologist eligible for a customary rate of $120 per hour would be paid $79.20 for the hour by Tricare, even if the psychologist’s standard rate is $150 per hour.

Active duty troops use Tricare Prime, a managed-care option maintained by private contractors. Their mental health care is free. Guard and Reserve troops and their families frequently use Tricare Standard, a fee-for-service plan. They pay an annual deductible and 20 percent of the amount Tricare pays the therapist.

John Class, a retired Navy health care administrator who now advocates on health issues for the Military Officers Association of America, said Tricare Prime contractors insist that the lower reimbursement rates has made it tougher to maintain a network of providers.

‘Starting to see the pinch’
“We are already starting to see the pinch,” Class said.

In a limited study by Tricare released earlier this year, about two out of three civilian psychiatrists in 20 states were willing to accept Tricare Standard clients among their new patients, the lowest acceptance rate for any specialty.

Any additional cuts in Tricare payouts could mean that “some really good psychologists who specialize in this treatment and are experienced will be seeing less of (military families),” said clinical psychologist Marion Frank, a widow who is president of the Philadelphia Chapter of the Gold Star Wives of America, a support group for military widows.

In parts of Montana, some families drive two hours to see a physician of any kind that will take Tricare, said Dorrie Hagan, state family program director for the Montana National Guard.

“When you get away from a city of any size then you start struggling for providers, and they’ll tell you flat out it’s because of the rate of pay,” Hagan said.

source: MSN News online


From Time Magazine Online:
A victory for mental-health advocates
source site: click here


Tallying Mental Illness' Costs


Senator Pete Domenici on Mental Health


When Congress approved the $700 billion rescue plan, it also passed one of the most significant mental-health bills in U.S. history — the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. It requires group insurance plans to cover mental illnesses the same way as physical ones (no more higher co-pays, deductibles and limits on hospital stays).

For more than a decade, Senator Peter Domenici pioneered the fight for such legislation. Last year, the 76-year-old Republican announced he suffers from a degenerative brain disease and would not seek another term. One of his final votes led to the bill's long-awaited passing. TIME spoke with Senator Domenici about the legislation's history, the state of mental health care in the U.S. and his hopes for the future.

Why do you think there is such a difference in the way insurance companies cover physical illnesses like heart disease and mental illnesses like schizophrenia?

First of all, it's pretty easy to see that people kind of frown on mental illness. If your neighbor has a heart condition, it's, "Gee, poor Jane, she has to take care of her husband." But if the neighbor has a manic-depressive son, you're kind of mad at them because the kid misbehaves. Unless you're a very, very considerate neighbor that's gotten close to the family, you can't quite understand why Johnny can be such a mean little child, why he does dangerous things. Well, the mom next door gets pretty frustrated, she doesn't know what to do and pretty soon, Johnny's in jail.


Parity of insurance is almost a civil-rights issue. We take care of people with heart trouble, we operate on them, we have great learning centers where we study all there is to know about the heart. And insurance companies have paid for all those surgeries. And yet, if you have schizophrenia, which is an illness of the brain instead of the heart, because we started off early on saying it wasn't an illness, we kept it and they wouldn't let us change it.

How did you feel when you found out the bill had finally passed?
You know, I'm going to be dead-honest with you, it dragged on so long that I didn't act like I normally would have. I wasn't like me. I [usually] get excited, passionate, but I didn't have any of those feelings because I was thinking it can't be real. It was more like, "It's finally over." It got so close and yet so far so many times. It's amazing, not only because we got it done, but because, for a nation, it has taken us so long.

Even in America in 2008, there are more people who are housed in jails that have a mental illness than there are facilities with trained help that were built to take care of them. By virtue of the fact that nobody else is going to do it, most police departments know that they're going to have them in their custody so they now train police in how to deal with the mentally ill. But it's all makeshift compared with what was intended when the Kennedy commitment was made way back yonder when he said let's open up these dungeons, where we had the mentally ill housed like beasts, and let the country build local facilities to treat them. America still hasn't faced up to it.

One of your major allies has been the advocacy group The National Alliance on Mental Illness (NAMI). Tell me about how you first got involved with them.

The Alliance has been the instrument of many, many good things. Our daughter was 17, going on 18, when she began showing symptoms of [schizophrenia]. We started stopping by their meetings after work and we quickly found out that, in spite of us having a child who had problems, there were so much more serious ones than ours. We ran into parents with two children who are schizophrenic, and they tried desperately to keep them at home and take care of them, and they went broke and the kids are in jail.

That's when I first started finding out about the issue, how parents were losing control of their children physically, and they were in jails because there wasn't any place to put them ultimately. If it's some average worker trying to find a place for their kid to spend a week or something for treatment and medicine, it's pretty damn expensive.

How does this bill address those problems?
This bill targets insurance plans that cover more than 50 employees. About 113 million people, we figure, are in group insurance plans that have, as part of their health care, mental health coverage. All of those, now, will have imposed on their insurance policy by operation of law that the insurance company will pay for mental health treatment in exactly the same way they cover physical ailments - the same amount of days in the hospital, the same amount of co-pay, and all the other technical words will be equal. And that's not what it used to be, and not what it is today. Insurance companies were already moving in that direction, but now we've made it so they can't slide backwards.

How do you think perceptions, both in Congress and among your constituents, have changed since you first introduced this issue in 1996?

Now when I'm finished with a speech and I'm mingling around - even if the meeting were oil and gas operators in Dallas, Texas - almost always somebody will come up and say, "Hey, keep with it, Pete, I've got a nephew..." Or, "My uncle Billy had this..."

In other words, it is more prevalent than you think. Out of almost any crowd somebody will tell you a story about their family. Those kinds of things are always coming up. Even President Bush spoke to me personally and very eloquently about it. He said, "You don't have to convince me, I'm over that hurdle." Every time we got close [to passing the bill], he'd ask about it.

Strangely enough, when I would speak to this among a group of Senators, it took more time than I thought to get some of them to come up and join me and say, "I want to work on this because I have a relative or a friend." But eventually, four or five Senators came up to me and said, "We got to work on this, Pete, because it's real." It took many a month until that first bill got to the floor. Then we just rolled it through the Senate. That was the first bill in 1996. And that's when it died in the House the first time.

How did you react when you found out the House had killed it?

Well, it wasn't like they killed it overnight. It was a lingering death. Until recently, we had a lot of trouble in the House at the top level under the Republican leadership, and as a Republican, I acknowledge that. And I was upset.

How did the vote on the $700 billion rescue plan affect the bill's passage? Were you worried it would get sidelined?

I had no concern. The economy is in bad shape in a number of ways, and it may be that we're going to have trouble finding out how to solve it, but at the same time life goes on, you know. Businesses are beginning to know that they have in their employment people who are mentally ill, people who have manic-depression, who have depression, who have schizophrenia, who suffer from alcoholism.

And businesses are finding out that they are better off giving them treatment and buying insurance that covers their treatment because if you can keep them well and get them their medicine, you add to their productivity and to your workforce productivity.

This is your last term in Congress. How do you hope your colleagues will take up this fight after you leave?

There are many things that I would still love to be doing, which makes my departure so hard. I would think the next thing to do is to introduce national legislation to start a program for a 50-50 match, where the federal government matches the local government in the construction of facilities that would be a local place for the mentally ill to be taken care of.
We're a nation that is really hell-bent on trying to do more and more for humankind all the time. I went to a clinic that handles little tiny babies that are born premature and they showed us what new equipment they have and how the baby can be saved and nourished at even a pound and a half.
We spend hundreds and hundreds of thousands of dollars to save little premature babies and that shows a real commitment on our part. And then we turn right around and, for the mentally ill, we have made it so difficult for so long to even say it's an illness that you just can't quite figure it out. We can do better.
source site: click here to travel over to Time Magazine Online

What is EFT?

EFT is based on a new discovery that has provided thousands with relief from pain, diseases and emotional issues. Simply stated, it is an emotional version of acupuncture except needles aren't necessary.

Instead, you stimulate well established energy meridian points on your body by tapping on them with your fingertips. The process is easy to memorize and is portable so you can do it anywhere. It launches off the EFT Discovery Statement which says...

"The cause of all negative emotions is a disruption in the body's energy system."

And because our physical pains and diseases are so obviously connected with our emotions the following statement has also proven to be true...

"Our unresolved negative emotions are major contributors to most physical pains and diseases."

source site: click here

More info right here at the emotional feelings network of sites! Click here

What is EMDR?

EMDR, or Eye Movement Desensitization and Reprocessing, is an innovative clinical treatment that was developed to deal directly with the effects of trauma. Since 1988, EMDR has helped over two million trauma survivors.

"EMDR is the most revolutionary, important method to emerge in psychotherapy in decades."
Herbert Fensterheim, Ph.D.
Cornell University

Fourteen published, controlled studies support the efficacy of EMDR, making it one of the most thoroughly researched methods ever used in the treatment of trauma. Most people treated for single trauma find relief from post-trauma emotional symptoms within three or four sessions of EMDR.

"EMDR was found to be an efficacious treatment for PTSD."
Practice Guidelines
The International Society for Traumatic Stress Studies
"The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing."
Bessel A. van der Kolk, M.D., Professor of Psychiatry
Boston University School of Medicine

What does an EMDR session consist of?

EMDR integrates many of the successful elements of a range of therapeutic approaches in combination with eye movements or other forms of rhythmical stimulation (such as hand-tapping). Once it has been determined which traumatic memory to target first, the clinician asks the person being treated to hold different aspects of that event or thought in mind and to track the therapist’s hand with his eyes as it moves back and forth across his field of vision.

As the session progresses, an innate self-healing mechanism is activated, and he is able to begin to cognitively and emotionally process the traumatic memory and disturbing feelings.

"EMDR provides a way for people to free themselves from destructive memories, and it seems to work, even in cases where years of conventional therapy have failed."
ABC News "20/20"

Once this mechanism is set into motion, the person undergoing treatment typically begins to spontaneously associate other memories, thoughts, and feelings with the originally targeted trauma. The result is a chain of associations, each of which the clinician may select as a target for additional EMDR therapy. By the time the various chains of association come to an end, the trauma has lost its negative charge and no longer maintains its destructive hold. It becomes simply another event in the history of the survivor’s life.

"EMDR is one of the most powerful tools I’ve encountered for treating post-traumatic stress. In the hands of a competent and compassionate therapist, it gives people the means to heal themselves."
Steven Silver, Ph.D.
Director of the PTSD Unit, Veterans Admin. Medical Center, Coatesville, Penn.

How does EMDR work?

The precise mechanism by which EMDR works to resolve traumatic stress is unclear, in part because we still know so little about how the brain processes intense memories and emotions. However, a number of neuropsychologists believe that EMDR enables the person undergoing treatment to rapidly access traumatic memories and process them emotionally and cognitively, which facilitates their resolution.

"We believe that EMDR induces a fundamental change in brain circuitry similar to what happens in REM sleep -- that allows the person undergoing treatment to more effectively process and incorporate traumatic memories into general association networks in the brain. This helps the individual integrate and understand the memories within the larger context of his or her life experience."
Robert Stickgold, Ph.D.,
Harvard Medical School

By accessing these memories in the context of a safe environment, the hypothesis is that information processing is enhanced, with new associations forged between the traumatic memory and more adaptive memories or information. These new associations result in complete information processing, new learning, elimination of emotional distress, and the development of cognitive insights about the memories.

"EMDR quickly opens new windows on reality, allowing people to see solutions within themselves that they never knew were there. And it’s a therapy where the client is very much in charge, which can be particularly meaningful when people are recovering from having their power taken away by abuse and violation."
Laura S. Brown, Ph.D.
Past Recipient of the American Psychological Association Award for Distinguished Professional Contributions to Public Service

After successful treatment with EMDR, affective distress is relieved, negative beliefs are reformulated, and physiological arousal associated with stress is reduced.

source site: click here

What is body-mind therapy?

Body-mind therapy combines the strengths of “talk” therapy with bodywork, such as touch, postural alignment, or exercises to increase body awareness. Also known as mind-body or somatic therapy, it helps people “become deeply aware of their bodily sensations as well as their emotions, images and behavior. Clients become more conscious of how they breathe, move, speak, and where they experience feelings in their bodies.” (United States Association for Body Psychotherapy). This increased awareness about how the body holds physical stress and emotional injury informs and directs the therapy process, allowing clients to work through patterns of limitation that are not often resolved on the level of the mind alone.

As the one of the innovators of body-mind psychology explains it, “Unacknowledged feelings from past experiences are stored in your body and then unconsciously have a powerful effect on who you are, how you behave, and how you feel about yourself. Using the body as the gateway to awareness, buried feelings and memories can surface, freeing you from old patterns and energy blocks that keep you feeling stuck and unable to live life to its fullest. Your mind may avoid certain emotions and memories, but your body remembers it all.” (What is Rubenfeld Synergy?)

Body-mind therapies vs. body work?

Bodywork seeks primarily to improve physical health and functioning. Schools of bodywork such as the Alexander Technique, Rolfing, and the Feldenkrais Method are examples of postural and structural body mechanics treatments. Though these systems also affect the emotions and mental states of the client, they are not overtly designed to work on psychological issues.

Body-mind therapy is a psychotherapeutic process that works on the relationship between the body and the emotional processes of the client, and is intended to address emotional concerns that are not as likely to be resolved through talk therapy alone.

source site: click here

Somatic Experiencing

Dr. Peter Levine developed Somatic Experiencing (SE) by observing how animals regulate and discharge high levels of energy when encountering life-threatening situations in the wild.

Unlike humans, who have been trained to use the rational faculties of the mind to cope with stressful situations, animals exhibit an innate ability to restore themselves to equilibrium after being attacked. They do not hold in their bodies the intense energy they needed to temporarily mobilize for survival.

Thus, they do not get traumatized as people do are after a frightening trigger event. As Dr. Levine puts it, “Traumatic symptoms are not caused by the dangerous event itself. They arise when residual energy from the event is not discharged from the body. This energy remains trapped in the nervous system where it can wreak havoc on our bodies and minds.”

Dr. Levine argues that humans also possess this energy-releasing ability, and can learn how to employ a body awareness he calls felt sense to renegotiate and heal the trauma. Learning how to access this felt sense in the moment and release residual tension is the basis of SE. The procedures are taught through face-to-face interactions between practitioner and client.

SE is considered valid for both shock trauma - single-episode traumatic experiences such as war, rape, or natural disasters - and developmental trauma, which refers to interruptions in the predictable psychological stages of growth.

Certified Somatic Experiencing practitioners, who are often psychotherapists, have completed a three-year training program through the Foundation for Human Enrichment, established by Dr. Levine. To find a qualified SE practitioner in your area, go to the Foundation’s Practitioner’s Registry.

The Hakomi Method

Hakomi is a method of gentle, body-centered therapy that operates from a core of five foundational principles:

  • mindfulness
  • unity
  • mind-body-spirit holism
  • non-violence
  • organicity

It was developed by psychologist Ron Kurtz, a practicing Buddhist and body-mind practitioner who wanted to develop a less harsh way of accessing body awareness. Hakomi is a Hopi Indian word that can be translated as “Who are you?”

The Hakomi Method works on changing those aspects of our core material - memories, body impressions, emotional imprints, habitual thoughts, beliefs, and attitudes - that were developed in response to challenging situations, but which limit our options when carried into adulthood beyond their usefulness.

At the root of Hakomi is Mindfulness - a deep listening to oneself, facilitated by the therapist guiding the client to stay totally present to what is happening inside during the therapeutic session. The past is referenced, but only as it needs to be for healing and completion, organically, as the flow of the moment dictates.

Hakomi does not try to change someone, but allows a person’s natural authenticity and self-knowing to emerge. It involves going beyond who you think you are, to being able to discover who you truly are - not through the intellect, but through the non-verbal wisdom of the body. This experience of being oneself cannot be thought; it must be experienced directly. The therapist is not an authority in this journey, giving advice or making suggestions, but a calm presence creating safety for self-discovery.

Briefly put, the Hakomi method can be summarized in three stages:

  • Establish a relationship in which it is safe for the client to become aware

  • Notice or evoke experiences that lead to the discovery of organizing core material

  • Seek healing changes in the core material

Hakomi therapists often help increase clients’ awareness of habitual patterns of behavior by sharing observations about their “body language” in a non-threatening way. These observations then form the basis of engaging in safe, mutually-agreed upon experiments that bring core material into awareness, such as practicing responding with different body language to a statement that reflects a deeply held belief.

Hakomi advocates the use of touch when appropriate, but only with the consent of the client. This distinguishes it from most traditional therapies, in which there are strict prohibitions against therapist-client contact. Certified Hakomi Therapists can be found through the Hakomi Institute’s website.

Sensorimotor Psychotherapy

Pat Ogden was a student of several body therapies and an apprentice to Ron Kurtz in the 1970s, when she decided she wanted to form a synthesis between body therapy and psychology, specifically the Hakomi Method she was studying. The result was Sensorimotor Psychotherapy.

Like Hakomi, Sensorimotor Psychotherapy uses a gentle approach to increase awareness of client’s underlying beliefs and attitudes. In this approach, the distinguishing emphasis is on its study of the relationship between trauma and developmental issues. Dr. Ogden was particularly interested in the dissociation from the body exhibited by many of the people she was trying to help, and through working with them discovered that:

  • Developmental injury occurs from dysfunctional family dynamics that lead to the formation of limiting psychological belief systems; and
  • Traumatic injury is due to perceived life-threatening events that overwhelm boundaries and leave victims feeling helpless and out of control

Sensorimotor Psychotherapy is known for differentiating between these two kinds of injuries and working with the interface between them. The methodology used is very similar to that of Hakomi therapy. It is founded on the same tenets of mindfulness, non-violence, organicity, unity, and holism.

The body’s sensations and cues are constantly referred to throughout the sessions, and establishing safety and respect is considered the first priority in the client-therapist relationship. A list of Certified Practitioners is available through the Sensorimotor Psychotherapy Institute’s website.

Rubenfeld Synergy Method

The Rubenfeld Synergy Method is a ‘hands on’ therapy that uses light touch and verbal processing to sense the movement of energy in the body, in order to help clients release stored emotions and blocks to more vital living. It was developed over thirty years ago by Ilana Rubenfeld, a Julliard School of Music graduate whose conducting career was sidelined by a debilitating back spasm.

Through seeking her own healing, she discovered a way to synthesize bodywork, psychotherapy and intuition into a method of ‘talk and touch.’ Ms. Rubenfeld describes the process on her website:

Emotions and memories stored in our beings often result in energy blocks, tensions, and imbalances. The Rubenfeld Synergy Method uses many avenues, including verbal expression, movement, breathing patterns, body posture, kinesthetic awareness, imagination, sound, and caring touch, to access these reservoirs of feeling. Together, synergist and client make room for emerging feelings, integrating them with present experience. (www.ilanarubenfeld.com)

The first ten principles and theoretical foundations of the Rubenfeld Synergy Method are:

  • Each individual is unique. Rubenfeld Synergists approach clients and their sessions with this principle of honoring their uniqueness.

  • The body, mind, emotions and spirit are dynamically interrelated. Each time a change is introduced at one level, it has a ripple effect throughout the entire system.

  • Awareness is the first key to change. By bringing the unconscious into awareness, clients have the opportunity to explore alternate choices and to develop possibilities for emotional, physical and psychophysical change.

  • Change occurs in the present moment. Clients may experience memories of the past and fantasize about the future, but change itself can occur only in the present.

  • The ultimate responsibility for change rests with the client. Rubenfeld Synergists can support clients to recognize dysfunctional behavior and guide them to try new ones. They cannot force clients to change.

  • Clients have the natural capacity for self-healing and self-regulation. Innate healing ability already exists in clients, waiting to be actualized. Rubenfeld Synergists do not "cure" or "correct" but rather facilitate clients' healing.

  • The body's energy field and life force exist and can be sensed. Rubenfeld Synergists use gentle touch to sense energy, its pulsations and movement. When tight holding patterns in the body/mind are released, there is a marked change in the energetic quality.

  • Touch is a viable system of communication. Rubenfeld Synergists develop "listening hands" to dialogue with clients, thus opening new gateways to their unconscious mind.

  • The body is a metaphor. Clients' postural positions and movements may represent emotional issues in their lives.

  • The body tells the truth. Often what clients communicate verbally is not congruent with their body's story. Rubenfeld Synergists guide their clients to listen to their body's message.

Sessions are typically 45-50 minutes and are conducted with the client fully clothed, usually lying on a table, although sitting and moving may also be called for at times. The Synergist guides the client in creating a dialogue between body, mind, emotions, and spirit. Repressed emotions such as grief, anger, and sadness are often re-experienced and given expression. According to the Rubenfeld Synergy Method website, the benefits of a Rubenfeld Synergy sessions can include:

  • Resolution of painful issues and experiences

  • Increased inner peace and calm

  • Greater self-esteem

  • Recovery from physical and/or emotional trauma

  • Maintenance of physical and emotional health and well-being

  • Better management of stress

  • Living more from conscious choice than from habit

A certified Rubenfeld Synergist can be found on the Locate a Practitioner page on the Rubenfeld Synergy Method website.

Integrative Body Psychotherapy

Integrative Body Psychotherapy (IBP) is an in-depth psychology based on the view that life is most fundamentally a somatic experience (somatic meaning “of the body”), and that the only way to truly understand oneself and the questions of life is through developing somatic intelligence. This intelligence could be summarized by the statement “the body always knows.” Every insight gained in therapy must be accompanied by a felt somatic experience in the body, a core experience of self. Psychological problems arise when the connection to the body’s basic guidance system gets interrupted.

IBP therapists help clients “track” three types of mind-body interruptions to the body’s basic guidance system:

  • Primary Scenario—emotional patterns and beliefs developed in early childhood that habitually distort present experiences;

  • Character Style—our protective defenses; and

  • Agency—how we abandon our core selves for love and approval

IBP does not employ physical touch in the therapeutic sessions, favoring more subtle means of putting clients in touch with their somatic intelligence. The basic tools used are awareness, breath, movement, and self-release techniques that empower the client to distinguish between disruptive psychological patterns, acted out in different arenas, and their core sense of self. Without this understanding that we are not our patterns, nothing can get resolved.

IBP also recognizes the difference between psychological and existential issues; the IBP therapist helps the client separate what are compelling personal patterns of emotion and behavior from the universal questions of being. These “bigger picture” questions of existence can also be understood through accessing the deeper wisdom in the body.

IBP uses the term fragmentation to describe what happens when a trigger event in life activates unconsciously held beliefs and emotional patterns, causing one’s world view and judgment to become distorted, and leading to hopelessness and pervasive negativity. Fragmentation is not seen as something that we can “think” our way out of, but an integrated body-mind-emotion response to past impressions imbedded in us. IBP offers quick-acting “steps out of fragmentation” that bring back balance and inner stability.

Integrative Body Psychotherapy was developed by Jack Rosenberg, Ph.D. in the 1970s and has grown to include eleven international institutes.

For help in finding a trained practitioner, go to the IBP website’s IBP Certified Practitioners page.


Simply put, Focusing is “direct access to bodily knowing.” It is a practice that takes a person towards a state of conscious perception that goes far beyond knowing something on a mere conceptual level. As with Somatic Experiencing, Focusing refers to this bodily knowing as a felt sense. As the Focusing Institute’s website explains, “You can sense your living body directly under your thoughts and memories and under your familiar feelings. Focusing happens at a deeper level than your feelings.

Under them you can discover a physically sensed ’murky zone‘ which is concretely there. This is a source from which new steps emerge.” This murky zone “opens” as you learn to stay with it longer. Being with it increases the ability to sense feelings behind words or images, even when those are not yet formed. Eventually, you can learn how to let a deeper bodily felt sense come in relation to any problem or situation. It is a subtle process, hard to define in words. It needs to be experienced.

Focusing was developed by the philosopher Eugene Gendlin in the late 1960s and early 70s, while he was working with the famed psychologist Carl Rogers. The process is widely taught to anyone who wants to learn it. It does not require a degree or certified professional to conduct, though you can find a Certified Focusing Professional through the Focusing Institute’s searchable database.

Neo-Reichian therapy

Wilhelm Reich, a psychoanalytic contemporary of Sigmund Freud, believed there was more to the process of resolving emotional issues than talking about them.

According to the Orgonomic Institute, “Reichian therapy was one of the earliest forms of body-mind therapy, combining dialogue, breath and movement to decrease body armoring.” Reich’s theory was that suppressed emotional traumas create physical tensions (protective layers he called “body armoring”). The premise of Reichian therapy is that specific physical movements, deep breath work, and physical manipulation can release both the physical and emotional tensions.

There are several forms of Neo-Reichian therapy that were developed in the 1960s by students of Reich. Their basic purpose is to free rigid muscles and patterns of movement in the body, which then allow the emotions to be freed, and the individual to live a more spontaneous and fulfilling life. The best known Neo-Reichian therapies are:

  • Radix – developed by Charles Kelly, a vision psychologist who used the Bates vision method. Starts with muscular tension in the face and head, and moves downward through the body. Techniques are applied according to individual needs; for example, a person who never cries has a different process than someone who tantrums like a small child. Certified Radix practitioners are often, but not necessarily, licensed mental health professionals, and all take a two-year training program. Radix practitioners can be located on the Radix International website.

  • Bioenergetics – developed by Alexander Lowen, who became a medical doctor after training with Wilhelm Reich. Starts with the pelvis and moves upward through the body. Uses yoga-like postures, stretching, breath work (sometimes with a “breathing stool” – a padded bench over which the person stretches backwards, to open the chest and spine). Active well into his 90s, Lowen wrote 14 books, including The Language of the Body. Certified Bioenergetic practitioners engage in a two-phase training over the course of 4-6 years and are required to be licensed psychotherapists. Certified Bioenergetic therapists can be located on the International Institute of Bioenergetic Analysis website.

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