CONTEMPORARY REICHIAN BODY TREATMENT WITH SURVIVORS OF GENDER BASED VIOLENCE

 

Cristina Angelini[*]

 DOI 10.57613/SIAR83

 

Abstract

 

A brief overview about how to work with contemporary reichian analysis in different cultural contexts with Gender Based Violence survivors. The specific role of body work in the healing process of GBV survivors, with a specific focus on domestic and sexual violence, is stressed. Bodywork, mostly done in group, proved to be very effective in the elaboration of traumatic experiences and in the empowerment process to achieve a more active role and a deeper awareness.

 

Key words

 

Contemporary Reichian Analysis – Bodywork - Gender Based Violence – Empowerment – Dissociation - Body levels - Acting.

 

 

I would like to share our 12 years experience in Middle East: Jordan, Syria and Gaza (but also Nepal and Tanzania) working on Gender Based Violence (GBV) using a bodywork approach. I worked as consultants in international projects (founded by European Union and UN agencies) meant to create Women Health Centers (WHC) and there was a cooperation with the local staff to organize Gender Based Violence (GBV) services inside a health care facility. Why GBV in a health facility? Because GBV is recognized as a public health issue and in many countries GBV diagnosis is possible only in RH services because sometimes the RH visit is the only health visit for a woman and RH staff are the only people to talk about intimate matters.

Moreover most victims will not disclose the problem spontaneously and studies show that they are usually not asked about GBV by health care providers (1). It's important to underline that GBV crimes are the most under-reported crimes all over the world and that they are still considered a private problem and not a social one. UNFPA defines GBV as both a public health problem and a human rights violation. I'd like to stress the specific role of body work in the healing process of GBV survivors (survivors of domestic and sexual violence in particular).

Sometimes I have worked in real emergency or conflict situations, like Palestine refugee camps in Gaza and Iraqi refugees camps in Jordan, or in situations involving social and institutional violence: strong honor killing risk in some areas, and general strong social bias and discrimination against GBV victims. Bodywork proved to be very effective both in the elaboration of traumatic experiences and in the empowerment process to achieve a more active role and a deeper awareness about their rights. It is often, but not exclusively, done in group, because groups turned out to be a resource to break loneliness and sense of shame, to experience mirroring, to offer a safe and warm space to grow up and to hold and express suffering. Bodywork is done throughout specific exercises to re-establish a contact with ourselves and to re-establish a trust relationship with others.

PTSD treatment, linked to domestic and sexual abuse, is very difficult because of the specific characteristics of these kinds of traumas, which are typically "encysted" inside the individual psyche, but also inside the family system, with a strong prohibition to talk about it. In the social system too there are many taboos preventing the disclosure of the violence that is generally viewed as a "family matter" and a "private problem". Also the shame is always put on the victim, particularly in sexual abuse, suggesting that the victim "did something wrong to provoke the violence". GBV victims are silenced not only by the perpetrators of the violence but also by society. When traumatic memories appear they usually have a typical structure: they are not verbal and narrative, but more often they are flashbacks, intrusive memories, interfering feelings.

During the past 20 years, the development of brain imaging techniques and new biochemical approaches has led to a deeper understanding of the biological effects of psychological trauma (2). Many authors agree about a neurophysiological common ground of these experiences, focusing on the "brain disorganization" and the interruption of the connections with the verbal areas. It has been observed that, while recalling the traumatic experiences, the Broca area stops working. Amigdala hyper arousal is also present, associated with a lower activation of the prefrontal cortex. (3)

A verbal reconstruction of the traumatic experiences is crucial to us, but at the same time we strongly believe that introducing bodywork is necessary, being aware of the high risk of re-experiencing the trauma while working on the body. The body is the "container" of those experiences, which are stored in it, and working on it is an important chance to overcome the original feelings and to re-elaborate them (4). Dissociation is a well-known phenomenon in these cases. Many people refer to feel detached from their own body and to watch at themselves from outside. This is a defensive mechanism to escape terror and impotence. The brain areas more involved in theses cases are those called as "reptilian brain", the most ancient part of our brain. It is crucial to activate a process of reconnection with more evolved areas, like those of the "limbic brain" and the neocortex, in order to achieve a functional elaboration and to leave the terror-panic-freezing state.

During bodywork every kind of reactions to the traumatic experience can reappear, that's why it is important to proceed slowly, step by step, never pushing people beyond their sustainability limit. We need also to create a trustful, holding and warm relationship. It is also crucial to help survivors to change their perception of the surrounding environment, acquiring a gradual sense of safety and diminishing the constant sense of menace.  Group work is specifically effective to this purpose, because groups can be a safe space where it is possible to experience trust, not only toward the therapist, but also toward other members who had the same experiences and who, sometimes, have already started their elaboration process. This is a crucial component in self-help groups, where facilitators are survivors of the same kind of traumas. In the Women Health Centers we created in Jordan, Syria and Gaza, we used to train some clients to become facilitators and to participate actively to the healing process of other women and also to produce a social change.

I want also to underline that domestic violence victims experience a particular type of trauma because the perpetrators of violence are usually the same people who have an emotional linkage with the victims and who are supposed to love them. There is often a very particular mix between love and fear and sense of guilty, and a double menace: from outside (aggression) and from inside (loss of object of love). In continuity with the Contemporary Reichian Analysis methodology (5), we usually propose a progression of exercises, called actings, having a sequence, which is flexible and adaptable to the situation of each particular group.

It is better to have two facilitators leading the group sessions and we always ask participants to keep confidentiality regarding GBV groups, especially in small environment (like refugee camps) where honor killing risk and general social stigmatization are present. We focus on the 7 body levels:

1°level: eyes

2°: mouth

3°: neck

4°: chest, arms

5°: diaphragm

6°: abdomen

7°: legs, pelvis.

Actings can be done alone, in pairs or in relationship with the whole group. We can work lying on the floor or standing. We can eventually use music. We usually start from acting enhancing affirmation and “muscular tonification”, in order to strengthen control and self-esteem. We then gradually pass to exercises to contact others.

We usually start from the eye level, the first level in body reichian-analysis, because eyes are crucial to understand and control the world around us. To support the capability of gradually activating eyes without falling apart and integrating disconnected feelings and sensations is considered very important.  In PTSD we have found that what is really crucial is to increase the client's control of her life, more that trying to "relax". Relaxation, especially at the beginning, can increase fear and arousal/alarm state. Eye activation, at the opposite, supports the capability of the victim of being in touch with the present time diminishing the interference of the past. We will not describe actings in details here.

Breathing is the fundamental element of life and modify breathing can modify totally our experience of the world. In GBV survivors breathing is one of the first function modified by the trauma (they can have blocks in the throat, on the chest or on the diaphragm). But we usually do not start working on breathing. We start from eyes and then, when eyes are reconnected, we move on breathing. Working immediately on breathing can be fearful at the beginning because it can move too many emotions. At the beginning we promote control, trust and self esteem. We have always to assess the clients’ sustainability and the sustainability of the group itself.

The debriefing of each acting is crucial in order to elaborate and integrate the experience also at a cognitive level.  I believe that after bodywork is necessary a verbal elaboration in order to take awareness of what happened and to integrate body and mind.

 

Bibliography

• A Practical Approach to Gender-Based Violence: A Programme Guide for Health Care Providers and Managers, UNFPA, United Nations Population Funds, Pilot Edition 2001.
• Solomon M.F., Siegel D. J. (2003), Healing Trauma: Attachment, Mind, Body and Brain. W.W. Norton, New York.
• Stupiggia M. (2013), Trattamento del trauma: un punto di vista neurofisiologico, in rivista PsicoterapiaAnaliticaReichina, n. 1 e 2.
• Ogden P., Minton K., Pain C. (2006), Trauma and the Body, W.W.Norton&Company, NY.
• Ferri G., Cimini G. (2012), Psicopatologia e Carattere, Alpes Italia.
• Nigosanti G. (2013), Psicoterapia in gruppo, linee metodologiche, in rivista PsicoterapiaAnaliticaReichina, n. 1 e 2.

[*]Psicologa, Psicoterapeuta, Analista S.I.A.R.