RELAXATION PSYCHOTHERAPY

At the urging of eminent neuropsychiatrist Julian de Ajuriaguerra, in the early 1960s a small group of psychoanalysts, all members of the Paris Psychoanalytic Society, attempted with certain patients to employ autogenic therapy, a technique inspired by hypnosis. Developed originally by German psychiatrist Johannes Schultz (1884-1970), autogenic treatment involved training a patient to experience well-being and comfort induced by hypnosis, more or less independently of a therapist.

Work with autogenic therapy soon led the group (Michèle Cahen, Jorge García-Badaracco and Marianne Strauss) to develop a psychoanalytic technique that aimed not so much to induce relaxation as to listen to bodily sensations. The observation that each patient experiences their own body in a unique way shifted emphasis toward resistances, perception of body image, and examination of the experience of relaxation itself. The principal psychotherapeutic tool became what Ajuriaguerra (1959) called the tonic dialogue. Spontaneous modifications of muscle tone develop in the course of any emotional relationship but almost always go unnoticed. These variations reveal the body's role in distinguishing pleasure-unpleasure and represent the first "language" of the mother-infant dyad. The goal of relaxation psychotherapy is not primarily to soothe the patient but rather to lead them toward "verbal expression of the states of one's own body." (Roux, 1968). Such states, rather than the patient's fantasies or stories, become the "signifiers" in relaxation psychotherapy.

The work of relaxation therapy takes place along two axes. First of all, it helps the patient to become aware of bodily sensations as experienced in the therapist's presence, and also helps the patient to formulate descriptions of them and to facilitate verbalization in terms of secondary-process thinking. At the same time, the therapist illuminates the role of the earliest objects in formation of the ego as revealed by bodily reactions in terms of the transference, which is more clearly in evidence. It seems apparent that the therapeutic work can take into account "behavioral" reactions without serious risk of inflicting narcissistic injury. Relaxation therapy produces in the patient a "passive" attitude towards endopsychic functioning and instinctual movements which are ordinarily in a "discharge" mode.

Unlike other similar techniques, relaxation psychotherapy does not employ suggestion. The therapist remains in the patient's line of sight and seeks to observe "what's happening with the body" while confining participation to helping the patient describe, in their own words, associated thoughts and feelings. The "tonic-emotional responses" thus discovered are reflected in the relationship with the therapist. This "detour" via the body places the therapist in the position of a primitive transitional object, introducing a third party into the relationship. Therapeutically, this facilitates recapture of secondary-process thinking, development of insight, and integration of behavioral phenomena that can be meaningfully interpreted.

Indications for relaxation psychotherapy include cases with severe underlying weakness in ego structure, whether with evidence of psychosomatic disorder or in patients suffering from narcissistic pathology.

Marie-Lise Roux

See also: Group psychotherapies; Psychotherapy.

Bibliography

Ajuriaguerra J. de. (1959). L'Entraînement psychophysiologique par la relaxation. Paris: Expansion scientifique.

Lemaire, Jean G. (1964). La Relaxation. Paris: Payot.

Roux, Marie-Lise. (1968). L'Expression verbale du vécu corporel. Revue française de psychosomatique, 14.

Roux, Marie-Lise, Dechaud-Ferbus, Monique, and Sacco, François. (1994). Les Destins du corps. Toulouse:Érès.

Roux, Marie-Lise, et al. (1993). Le Corps dans la psyche. Paris: L'Harmattan.