[Body and Mind Central]Contact Dr. Lewis

I aim for a clinical encounter in which there are two people in the room. I mean by this, not an "expert" therapist who diagnoses the problem and fixes it for an objectified, compliant patient. What I prefer is that we both discover how it can be safe enough, with two of us in the room, for my patient to begin to tell his or her story. That story, of past events and relationships, is embodied in the patient's psyche-soma. In the spontaneous exchange, sometimes implicit and nonverbal, the relational story becomes known as it is relived, this time in a safer context. I remain the responsible professional, but I am also a guide who is touched by this journey into such personal places. See publications for relevant clinical vignettes.

 

Background

I have 30 plus years of experience as a psychiatrist and Bioenergetic therapist practicing in New York City. I am fluent in both English and German and I am an active member of The American Psychiatric Association, The International Institute for Bioenergetic Analysis and The Mount Sinai/NYU Medical Center as a clinical faculty member.

From the early 60's I was at or very near the center of bioenergetics. I was personally drawn to a body-centered therapy because my own wounds (symptoms) expressed themselves in the premetaphoric reality of my body, its sensations and feelings. I was part of the excitement of the small group in New York City started by the three founders of Bioenergetic analysis: Alexander Lowen, John Pierrakos, and William Walling. They were at different times, therapist, teacher and mentor to me. For close to 10 years I attended the clinical seminars run by Drs. Lowen and Pierrakos. In 1971 I was a founding member of the IIBA faculty. Although I preferred writing, teaching and working with patients to being an administrator, I served as clinical director of the IIBA in the mid-70s. I have been a senior faculty member of the IIBA for about 30 years, during which time I have taught in our training programs in many places around the world. Increasingly, over the years I have done more continuing Bioenergetic education with post-graduate groups.

Ten years ago I rejoined the faculty at the Mount Sinai/NYU medical center. I did this to better bring myself up to date on the explosion of recent neurobiological (actually psychospiritualneuroendocrinobiological, etc.) research. I felt it important to better understand the details - the subtleties and complexities of the relationship of psyche and soma so as to fill in the big picture that Reich and then Lowen so brilliantly outlined for us. There were exciting new, scientifically rigorous, findings from attachment research, for instance, which I thought should inform our Bioenergetic model. There was modern trauma research and literature that both enriched and confirmed the power of our Bioenergetic approach: we understood the language in which the body encoded unspeakable trauma. We were trained to carefully bring that sensory-motor experience to a spoken narrative, a comprehensible story from a time and place in the patient's life.

My medical background adds a particular synergy to my Bioenergetic approach that is not easily defined. In part, it is about my having some familiarity with the anatomy, physiology and pathophysiology of our psyche-somas. It also has to do with my having been exposed early in my career to the realities of birth, death, illness and healing.

On the other hand however, neither Reich nor Lowen worked out all the quite important details that arise as we move from the prototypical single-celled amoeba to the trillion or so-celled human being. The devil, as they say, is indeed in the details when things go wrong in the psyche-soma. My colleague, David Resneck-Sannes, an internist suggests, for instance, that while you might expect every medical condition to have a psychological correlate, this correlation may be extremely complex. It may Resneck-Sannes notes, be mediated, on limbic-thalamic-autonomic-pituitary-endocrine levels.

The point is, that while noting the immense power of seeing the organismic unity of a trillion cell system, we must respect the fact that "duality" does not capture the many, many levels of organization and description on which we may need to intervene with real people. I mean by this, for instance sensing how crucial a person's sexualit or spirituality or their relationship to a sibling is to them and asking about it. I mean, for instance realizing that a well-attuned touch - verbally or physically rendered - can alter a person's gene expression.

A Bioenergeticstate of deep despair or terror may predispose/trigger/maintain any number of medical problems. For instance, as a physician working with a traumatized patient who's asthma is part of her story, I am obliged to be aware that the details of her asthma could assume a life of their own and kill her. I ask her to keep a pump bronchodilator at her side while we Bioenergetically explore the anguish, terror and rage that is encoded in the smooth muscle of her bronchi. I believe that some mix of my medical background and Bioenergetic training gives me both respect for, and awe of what I do not know and what can go wrong and the courage to work with a person on a deep psychosomatic level.

I am reminded of a young man I worked with about thirty years ago. He suffered from a rare, potentially fatal immune disorder of his gastrointestinal tract. Since his adolescence the steroid medication he was on had enabled him to live a somewhat normal life, but he had (I do not remember all of the details) gotten the permission from his endocrinologist, with my support, to try to reduce or perhaps even wean himself off the steroids (which had potentially serious long-term effects). I believe I had enough respect for his illness to consult with his specialist, and to proceed with caution, but also enough respect for the power of Bioenergetics to believe that we just might help my patient to reorganize himself at a fairly deep level of psyche-soma (see Reich's dialectic diagram). I believe that this mix of awe and understanding on my part gave my patient the holding relationship that helped him through the slow, painful process of discovering his body and its feelings without steroid medication.

Developmental Thinking

While I was already deeply involved in Bioenergetics, and had finished my basic medical training, I took a four-year psychiatric residency at the Mount Sinai hospital in New York City. I spent two of those years on the child and adolescent services. Thus early on, I was exposed both to the depth and power of Reich's psychosomatic view and the developmental thinking that began in the well-baby clinic and had been so well elaborated, for instance, by the pediatrician and psychoanalyst, Donald Winnicott (see my 1983 paper, "Cephalic Shock as a Variant of the False Self Personality". Trauma and wounding in the earliest, preverbal years of life, have been and remain, abiding interests of mine. (Lewis, 1974, 1976, 1983, 1985, 1997, 2000)

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Relational Thinking

In my early writing (Lewis, 1974, 1975), I tried to bridge the two worlds which had informed my views of therapy: that of a> the then mainstream psychoanalytically-oriented psychiatry, and b) the Lowenian Bioenergetic. I maintained that there was always a relational significance to any body work done in a therapy. Thus, "body work" done in a therapy process was always done in the context of a relationship between patient and therapist. What we all have embodied is the history of our attachment and bonding with our significant others. Therefore the spontaneous expression of the body in the therapy will also be a relational rework in progress: two people in the room, effecting and being affected by each other. (Lewis, 1997, 2000)

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Working With the Head-Cephalic Shock

A totally different perspective on why people turn to body-oriented therapies; not only, as Wilhelm Reich said, because civilized men and women suffer from a mind/body split, but, additionally, because some of us, who have lacked sufficient attunement from our caregivers, suffer the specific mind/body split which I call "cephalic shock". This means we, from infancy on, unconsciously hold on to ourselves with the deep structures of our heads. When we grow up, we experience our minds as cutting us off from our deeper vitality. We are more or less tormented by our incessant thinking. The breath of life does not quite move up into our heads and we never know peace of mind. Recent attachment research has described a category of insecurely attached children - "disoriented, disorganized", which bears striking resemblance to the children I describe as "cephalically shocked" in my writing. Recent neurobiological research suggests that this fear of the spontaneous movement of our heads, creates a vicious cycle in which an already vulnerable balance system becomes chronically impaired.

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DISCLAIMER: The diagnosis and treatment of psychiatric disorders requires trained medical professionals. The information provided below is to be used for educational purposes only. It should not be used as a substitute for seeking professional care for the diagnosis and treatment of any medical / psychiatric disorder.