Norman Allan

The Dialogue between Mind and Body in the Clinical Setting

Norman Allan

Abstract: (click here)

Sister Catherine pointed out to me once, apropos of body, mind and spirit, "It's not a third part mind, a third part body, a third part spirit. It's a hundred percent mind, a hundred percent body, a hundred percent spirit." She also noted that spirit is intrinsically mysterious. Then again, so is mind - many scientists feel they can reduce consciousness and experience to a pattern of electrical charge and that, to me, is pretty mysterious. And that leaves us the body. We've learnt lots about the body, except in that it is alive and there too is a mystery. We are doomed then, and blessed, to walk and work in this mystery.
     When I was studying Barral's Visceral Manipulation (with Frank Lowen), I was feeling the sigmoid colon, pulling on the tension in the sigmoid mesocolon of one of my class mate and there was this "knot", this tension in Lee's mesocolon that wouldn't release with breath or through simple intentional exercises (like asking, "How would this energy like to release?" and then inviting the patient to visualize that release). So we did a "scenario". "Scenario" work is what I call variants on going inside, taking whatever resources you need to feel safe, saying what you want to, doing what you want, and having it turn out the way you want; that is, moving the scenario towards resolution.

     "Go inside. Into this spot…" I was tugging on Lee's abdomen, lower left quadrant, on this fascial locus of tension, contraction? that I identified and labeled as the sigmoid mesocolon. "What do you see?"
     "I see a door," Lee said. He visualizes easily.
     "Can you open the door?"
     Lee laughed, "Yes." (Nowadays I'd ask first, "Is it safe to open the door?")
     Lee opened the door on to his childhood front yard, the path leading to the gate. Down by the gate was a German Sheppard that had bit him when he was twelve years old. "He gave me this scar," Lee said pointing to his brow.
     Lee "went inside". He reported after that he told the dog to stay; the dog stayed. He told the dog to sit; the dog sat. Meanwhile, I was pulling gently on the mesocolon and at some point the tension just dissolved, like butter, and with this there was a little blast of heat!

Now, this underlines and/or suggests the following: that we store our traumas in the body, and in particular in the belly; that with trauma there may be a tightening in the gut, and we anchor events, and reactions, constellations of experience, in the viscera, first as a contraction of smooth muscle, a cramp or a spasm in the mesentery or mesocolon, for example, and that as that knot or tension is held the collagen changes its conformation, coils, shortens; and then, that contracture holds a memory, as it were, or rather it is a key to an "association", to a constellation, a pattern of event and issues. So, we have here a mechanism for repression: store it in the belly and ignore it.
     Why in the belly? Well, the felling in the guts is part of the experience and… we can make these anchors, these contractures there and… the belly is a convenient place to ignore, and hence repress. Perhaps we simply use this mechanism because it's available. Like so much else, it may be fortuitous.
     The amazing thing, to me, in the incident I described, was that the collagen would release like that, in an instant, as Lee revisited and re-wrote his drama. The collagen unwound releasing the energy, the heat, that that change of conformation, that that coiling had held these years. Our collagen, our fascia, is alive. It is responsive.
     One might ask, is this the only mechanism, or the main mechanism for repression? It is part of the picture. Accompanying a trauma the muscles in the gut contract, the collagen conforms, contracts, and takes up a contracted posture, position. And if you multiply these contractions you can get constrictures of surgical proportions.

Cynthia had a contracture in her gut, in the later third of her ileum, five centimeters long on the barium swallow. She had not eaten, or passed stool, for eight days and was scheduled for surgery. I was asked to visited her in hospital on the eve of her operation. We talked, some about white flowers, her mother and white funereal flowers. We also did some CranioSacral hands on "unwinding" over and under that contractured spot in her gut along with "visualizing". Cyn saw a prawn-like pink embryo, in her gut.
     Did it have a name? I asked.
     "Maybe Cynthia." (The patient's name was not Cynthia.)
     Did Maybe Cynthia have a message?
     "Yes. The message is "No"."
     "No, I don't have to die." And with this ideation, realization, there was a "release" and my hands seemed to move three inches laterally (back towards me) and, after a pause, a second "release". My hands followed the tissue and now they seemed to travel three inches superior (cephalad). And Cynthia and I "knew" that the problem had resolved, that the constricture had released.
     She was radiant.
     In the morning Cynthia passed stool and she was hungry, so instead of surgery, she had breakfast. The hospital served her bacon and eggs!

Ah! the "three inch" movement of my hands that appeared to accompany the "unwinding", the release of the constriction? It had to be in some sense symbolic - a ritual that I had unconsciously devised - or at the very least it was a gross amplification. And the vectors, the direction was "wrong". The release, very likely, was radial, of sphincter like muscles, not lateral.
     And that brings to mind another unworldly aspect of this sort of bodywork, this dialoguing. In the Barral's visceral work, to work with the kidneys we lay our palms, our hypothenars, on the abdominal wall at the level of the bottom pole of the "kidneys" and we follow the movement. But the kidneys are three or more inches away (at the back of the abdomen)! So I often say to the patient that the contact is like a Star Trek tractor beam. Similarly we can "stretch" the ureters by placing a thumb down near the pubis to pin down the bottom of the ureter, down near the bladder, while placing the other hand on the inferior pole of the kidney, as described above, and pushing it, encouraging the kidney in a cephalad, a head-ward, direction to stretch the ureter. And patients will usually report that they can feel the stretching of the ureter, though it's physically far from our contact on the anterior wall of the abdomen. More tractor beams, but it leaves us with the question as to whether this manipulation of the abdomen is mechanical, "energetic", or symbolic? And, of course, the answer is probably all of these.

John Upledger, of CranioSacral Therapy, believes that we store our "repressions" in the viscera because of a relative stability there, and the striate muscles of the musculoskeletal system, the muscles of movement (and their fascia) move about too much to act as storehouses. Yet there certainly can be restriction in the locomotary fascia and these, like the tension in the visci, can be released through intention "energetically". They will interact (as determinants and products) with posture and attitude.
     Upledger sees symptoms as a way that we get the body to talk to the self: - vehicles of Freud's return of the repressed. Sometimes we can see them as metaphors. (Michael Vertolli, my herb teacher, says symptoms are simply the body's best way of dealing with a problem. Suppress a symptoms and the body will find the next best way.)

Another tangent: there's a "clever" thought I had about the gut long ago when I was young which I've never written down anywhere, and it's almost relevant here. As a child, and infant, like many I suffered on occasion quite nasty "stomach" pains, cramps. And from the age of twelve I was in therapy. I was raised a "Freudian". The thought was this: that the gut is experienced more as a sequence of events in time than as a spatial structure. The gut's rather randomly there inside in our somewhat amorphous bellies. So, I thought, what the intestines represent is sequence and consequence and that it is the archetypal snake, serpent, and dragon.

We should talk, at least briefly, about safety, and about projection, and boundaries, and "copping out".
     Safety: remember to ask the patient about safety whenever you suspect it might be an issue. Of course, resistance grows as we approach the repressed. One way of dealing with this is to dialogue with the higher self. In CranioSacral work, Upledger often get his patients to initiate such a dialogue. Dialogue with "higher self", be that spirit of intuition or whatever, can be employed to help look after safety, and indeed, to help with almost anything.
     Projection: when we leave the therapy to the patient we can minimize our projections, but when we contribute there is always a risk. I try to stay aware of how prone I am to project and I often preface my contributions with a caveat warning about projection. But, how much should the facilitator contribute? When I was studying "dialoguing and imaging" at the Upledger Institute, there was one T.A. who pulled virtually all her patients off the table to try and rebirth them. She tried to make everyone conform to her conception.
     How can we make sure we stay with the patient's agenda if we contribute? And should we contribute?

Marsha came to my office for chiropractic for low back pain, which we helped, but she liked the CranioSacral work and she returned for more. So I was sitting with my hands over and under her right thigh when a thought arrived which I felt called to voice. (I've never said anything like this before or since.) I said, "It's as though there's a microfilm embedded in your thigh."
     "Oh my God!" said Marsha. "I dreamed last night I was in a submarine. I was a spy and they were looking for the microfilm. It was hidden in my left thigh. They tied me to the periscope.'
     Marsha had forgotten her dream after waking and during the day, but she had never repressed what it alluded to. She told me that from the age of three till she was five her mother used to take her down into the basement, tie her up to a round pillar, a cylindrical floor support, and whip her thighs with electrical wire. From the age of three Marsha knew that her mother was mad, crazy. She was still looking after her mother, at twenty-five, but about leave home to travel east. She sent me a happy postcard from Katmandu. She had never forgotten the abuse, but she had never spoken of it (so spirit engineered a dream and some telepathy so that she would speak).
     Mind, body, spirit overlap and the boundaries between them are not really understood. Contemplating the question I get tongue tied and boggled.
     And "boundaries"? I'm left with the New Ager's dedication to the "highest good".

We might also have segued from "projection", to how often we may be "missing the point" and from this to the danger of "copping out". My friend Vanessa practiced a variety of mind body dialogue out in B.C. She had a male patient with a pelvic cancer. He visualized the tumor as having five tentacles. After surgery the tentacles were still there. Vanessa and he dealt with three of them - they disappeared from Frank's image - but then they got into a bind. Frank had abused his teenage stepdaughter. Vanessa and he felt that one of the remaining tentacles related to this, however, when they came to address this issue, the patient started acting out very suggestively in a manner Vanessa found she didn't want to handle. The eminent innovator of the therapy Vanessa practiced was about to lead a large seminar in Toronto. Vanessa raised donations in her clinic to fly her patient to Toronto so the Eminent could work with him. The Eminent choose to work with him in public session where the cancer told the patient that the issue was around creativity. That what he needed to do was to give up his hack day-job, editing, and work on his novel. Vanessa felt strongly that this was a huge cop out. She felt let down.
     How do we guard against copping out? Ah. We can return to the feel in the body. Phil Walsh, in his scenario work, which he calls Autosomatic Training, uses feeling - feeling are usually located in the body - and we can use feeling as a guide towards truth and towards completeness.

I feel I should tell you about Gorginski's mice: Greg Gorginski was a colleague of David Ader, the author of psychoneuroimmunology. They were working with tumor-prone mice and wondering why tumors manifested in some mice and not other. Using an "Open Field Test" they found that the tumors manifested in the "emotional" mice (the scored of micturation and defecation in the first five minutes of a stressful experience, the open field, and probably a measure of autonomic sympathetic tone). So Greg bred the most "emotional" and the least "emotional" mice, for eight generations, till he had some very emotional and some very calm mice indeed. Then in the ninth generation he cross-foster the mice: he gave the "emotional" pups to calm mothers to raise, to suckle and the calm pups to "emotional" mothers, and it's who gives you suck that determines your emotional tone!
     Now I assume it's the "vibe" of your mother that sets your tone, but I was telling this story to an eminent doctor, a pain specialist, and she assumed it would be some factor in the milk. And indeed we might expect more adrenaline and adrenaline derivatives in the "emotional" milk. So is this body or mind, and where are the boundaries? The dialogues between us are usually of both mind (verbal) and body-talk… and what else?

Finally, I'd like to tell you about Michael's liver flukes. After returning from the south Michael was determined that he had parasites (though stool sample were negative). In my office Michael visualized and dialogued with his flukes. They saw his liver as a golden sun. There were dark patched in his liver. The liver flukes ate and cleaned up the dark parts. They worship his liver and tended it, and if Michael would give up junk food and coffee they would agree to pass on (through their eggs, their progeny) to another host.
     Sometimes our symptoms are more concerned about our well being then we are, even parasites from a distant phyla, and even if it is all just in our minds. Sometimes our symptoms are metaphors, though looking too hard for metaphor can sometimes be another cop out. Sometimes our dialogue may be completely off point: stuff and nonsense.

Mind, body, spirit, where is the divide? I had another clever thought the other day, though probably one that's as old as the hills: -
     There is more to the mind than the body. Though the mind embraces the body, the body is only a small part of the mind. And one can say the same of spirit and mind: spirit embraces the mind, but mind is only a small part of spirit. So we walk and work in the mysterious.


Summary: we described how:-
trauma may be associated with smooth muscle contraction and changes in conformation of collagen;
these changes are responsive;
the abdominal organs may be specially suited to "file" repression;
these "anchors" can become symptomatic;
our interaction with them as facilitators may be mechanical, "energetic", symbolic;
anchors may be stable for years and they may change in an instant;
projection is always an issue when the therapist contributes;
the boundaries between mind, body and spirit are enigmatic;
the patient come to the office with an agenda and our job is to facilitate this;
we spoke of the possibility of "copping out";
and we talked about sympathetic tone and how it is communicated,
and we talked about mystery.

see also: a meeting with marion woodman  

delivered 5th June, 2007 at the
4th Critical Multicultural Counselling & Psychotherapy Conference:
Dialogue with the Body in Clinical Practice -
University of Toronto,
Ontario Institute for Studies in Eduction,
Department of Adult Education and Counselling Psychology,
Centre for Diversity on Counselling and Psychotherapy.