“Have you ever received gifts? “I was asked by one of the neuro-linguistic programming specialists. Apparently, he wanted to “anchor” my state in my process of recollecting the pleasant experiences corresponding to receiving gifts, and then use it for some purpose which was unknown to me. I do not know if that specialist achieved his goals, most likely not, but I am grateful to him. When I conscientiously turned to my experience, I was horrified to find out that I could not remember a single occasion when I received gifts, until I suddenly realized that the main gift is life itself. All the others are simply lost in comparison with it.

Who made this gift for me? I do not know. But I know that my parents, who managed to survive difficult times, are a big part of it. I am grateful to them for their viability and for caring for me. This applies to all my relatives. My positive thinking, or even more broadly, my positive attitude to life is owing to my mother Elena Sergeyevna, who was also my first school teacher, and all my other teachers, among whom I remember with special warmth Galina Alekseyevna Kolobina, Valentina Konstantinovna Tarasova, my History teacher Mikhail Ivanovich Chekalin; my Philosophy teacher at Medical University lion Semyonovich Chernyak, Professor of Psychotherapy Mark Evgenievitch Burno, my internship tutor Vladimir Elizarovich Smirnov, whose clinical thinking is still a model for me; my associates Vyacheslav Nikolaevich Tsapkin and Vera Kerpelevna Loseva, who helped me, a doctor by training, to get closer to the psychological vision of a person; my friend, a “symbolic primitivist’ artist, Vladimir Boldyrev, whose creativity prompted me a number of ideas; all my patients, without the cooperation of whom this book would not appear.

I thank all my colleagues. I especially would like to mention Igor Kanifolsky (St. Petersburg), Alexander F. Bondarenko (Kiev), and Steven Shoen (USA). The experience of their work and behavior were significant for me. Thank you to everyone I have ever met.

Andrey Ermoshin

To the english-speaking readers

«Things in The Body» is the first of a series of books that describe Psychocatalysis. It has been published in several editions in Russian and has already become a kind of classic for a whole generation of specialists. An increasing number of psychotherapists are adopting the ideas of this book: to organize the reverse development of symptoms associated with the experience of problems and injuries, to lead the patients to calmness and regeneration of their state without re-traumatization and without provoking catharsis.

In most of the cases catharsis is not only useless, but also harmful. It gives just temporary relief. It does not solve the basic problems of a person, but, on the contrary, it aggravates them. Nowadays many specialists come to understanding of this fact, whereas, when the first edition of this book was published about 20 years ago, it was not so obvious.

To psychologists and even some naive doctors, the psychodynamic approach, with its working through resistance and unleashing the repressed reactions of the body, seemed attractive, although it is only an imitation of psychotherapy.

Such seduction by seemingly effective work led to many secondary problems of the patients: loss of time, effort, and resources. For some patients and clients that was fatal. They committed suicide or, having passed into the category of psychiatric patients, had miserable life under neuroleptics.

Psychocatalysis, as an alternative approach to working with neurotic patients, goes back to the traditions of the inner practices of Orthodox monasticism and, in part, to the healing traditions of Russian people. It is in this tradition that the hysterization of a patient is not welcome. What is practiced is the «shrinkage of passions’ and «laying off’ the perceived provocations on them, «letting go of fears.»

I hope that the English-speaking readers, whatever culture they belong to, will be interested in correlating their approach with this «Russian’ approach.

Other books on Psychocatalysis: «Phobias, Disappointments and Grief: A Fast Remedy», «Learn Languages Easily: Methods of Self-Regulation for Successful Learning» are also available in English. Other books: «Geometry of Experiences» and «Enigmatic Syndrome: Panic Attacks and Their Treatment" are in the translation process.

I will be glad to get your feedback: erm@list.ru.

Have pleasant and useful reading!

Author’s preface

My given body – what to do with it?

It’s so mine and so fit.

Josip Mandelstam

Two patients are talking in a surgical ward in the presence of a third person who has just regained consciousness after an operation: «Our surgeon often leaves things in the bodies of his patients. «He left a glove inside me,» says the first one. «…and I had his hat,» says the second. The newly operated patient looks at them with concern. At that very moment, the surgeon comes in and asks: «Has anyone seen my coat?»

Things in the body… First of all, I would like you to note that we are not talking about things forgotten by the surgeons in the bodies of their patients, but about the objects in the ’body’ of consciousness left there by the people themselves. They are not tampons or scalpels, but anger and resentment, disappointment and sorrow, jealousy and anxiety. Though these ’objects’ cannot be seen with X-rays, their effect on our health is disastrous.

Fuel

We usually speak about feelings, emotional charges, or affections (as psychiatrists call strong feelings, which arise in extreme situations) not as items, but rather as something fluid and striving for expression. Love leads to hugs, disgust – to repel, anger – to kill, and compassion – to heal the wounds of a neighbor. An emotional charge is sort of “fuel’ that drives a particular action.

Is that what nature conceived? When the «action’ is done, a feeling of satisfaction comes. All would be well, if not for situations in which emotions do not find their natural way out.

A person is burned

What happens to a charge when it cannot be released? Such emotions can be left “burning’ for many years if there is no way to send them to their “addressee’ or “to cancel them’. Then a person burns. In some cases, those emotions “burn out’, leaving behind an unpleasant “sediment’.

The «fuel’, which was originally light, thickens to the consistency of gas, gas – to the consistency of liquid, then liquid – to mass, and mass – to stone. Finally, we get a «petrified emotion’. Sometimes the human soul is left holding these «stones’ of mental anguish. As the cause of these emotional charges originate from the outside, we can think of these «stones’ as «foreign objects’, which are difficult to experience, understand, and to convert.

The situations that trigger strong feelings are different, however, both petrified emotions of «our own production’ and these «stones’ or «foreign objects’ that have been taken into the soul from the outside, are capable of disturbing the human condition…

A heavy stone pulls to the bottom

The basic form of loss associated with the carrying of “stones in the bosom’ is a distraction from perception and activity. The feeling of resentment in the chest “depresses’ the hands, the feeling of fear in the stomach influences the legs and all other parts of the body. Attention is taken not only from the parts of the body, but also from the parts of life. A person is “wrapped’.

Collected negative charges are not only stealing a person’s potential. They also distort it, and therefore increase the risk in a person’s life. This risk affects almost all areas: health, family, work.

Talking about health, such a risk, under certain circumstances, comes out in the form of psychosomatic diseases. The most common of them are gastric ulcers and duodenal ulcers, hypertension, bronchial asthma. The whole list occupies a lot of pages in medical manuals.

In the sphere of interpersonal relations, the harm caused by untreated lumps of resentment in the chest, or balls of irritation in the temples, or the fog of anxiety in the forehead, etc., is well known to everyone. They lead to those «twists’ in our relationships that make life so difficult. The destinies of entire generations, peoples, not just individuals and families, are collapsing. There are more than enough such examples in human history.

Creative activity also suffers from the emotions which do not find their outcome. A person does not fully use their potential and unprocessed charges spoil the results. Not to mention the fact that a one-time failure in psychic functioning can cost a person their life. A heart attack, a fight, a fatal mistake at work – the risk can manifest in thousands of different ways, and it «knows how to wait’. I do not think we should let it just happen.

Something must be done

Everyone intuitively understands this. We rely on our self-regulation: the body seeks to solve problems while asleep, or in the process of life itself. However, when in stress, self-regulation fails, and time is not a cure.

In such situations some people use alcohol or drugs, but they cannot solve the soul’s problems. In cases of failure of the body’s self-regulation, many people turn to a psychotherapist. At the same time, patients often ask the question: how do you expect to help me?

Something new

It is not about medicine, hypnosis, or psychoanalysis. Though, all of them can be used. We are going to talk about working through sensations.

This is an amazing kind of work when such expressions as «lump of resentment in the chest’, «a fog of anxiety in the forehead’, «a steel plate of control in the back of the head’, «a jellyfish of fear in the stomach’, and «a dagger of betrayal in the back’… sound like a diagnosis. «Cupid’s arrows in the heart’ seldom become a reason for complaining. People more often consider them a sign of happiness, though, not always knowing what it really means.

You do not have to be in delirium tremens

Maybe to find such “things’ inside one’s own body a person needs some special conditions? For example, is it necessary to be poisoned with ethyl alcohol to the state of delirium tremens? The doctor holds out an empty hand to the patient and asks:

«What is in my hand?»

«A wire.»

«What will you do with it?»

The patient starts to wrap it around his arm.

Is anything else needed to help people to realize what they are «carrying’ inside their bodies? Not at all! Moreover, it is not about the understanding of what is absent, but only of what is really present.

A person, encouraged by a few questions, is able to describe the «content’ of their inner space. However, they are invited to advance in this a little further than they usually do.

How many cats are there?

Very often people describe their anxiety as “cats are scratching my heart’, “my tower is bursting’, etc. In such cases a psychiatrist begins to think about the medicine for a patient and a psychologist studies the conflict in the relationship that gave rise to such a state, but it is very unlikely that the patient will be asked the clarifying questions: “How many cats? Color? Size? Did they start to tear your heart at the same time or one after another? Are the walls of the tower thick or thin? Is there anything gaseous or liquid in it? Is it like a mass or like a solid body? Anything else?”

Therapy based on sensations opens an amazing opportunity through such questions to go to the energy charge associated with the experience.

The mouth of a shepherd

I was in my early twenties when I was attacked by a male shepherd dog. In the moment, when I saw its open mouth, I automatically put my hand in and grabbed its tongue following my father’s advice. So instead of closing its jaws, it tried to unclench them as much as possible. However, I did not know what to do next. The idea is to swing the dog away. Unfortunately, I realized this later, and had to wait for the owner to arrive. When I let the dog go, it bit my forearm. I still have scars from its teeth.

Why am I telling you this? Well, somatotherapy is something like inserting your hand into the mouth of a shepherd: a movement by the shortest path, then an open confrontation with the agent upsetting the consciousness, «grasping the tongue’… As we see, the most important thing is to understand what to do next.

Three types of psychotherapy

According to the tradition started by Freud, most types of psychotherapy seek to bring out what is “hidden’ or “pushed back’. They consider dreams, free associations, and other manifestations of human mental activity, often similar to a complicated cipher. With the help of a secret code, which is known to a highly experienced psychotherapist, it is possible to open the deep mental movements of the patient during their collision and resolve the conflict.

This applies to the so-called psychodynamic tradition in psychotherapy, working with the content of symptoms in the in the collision of the soul’s motives. Since this approach considers the meaning of symptoms, it can be called psychosemantic.

The so-called clinical psychotherapy is not so interested in the meaning of symptoms, but very closely examines the basis on which they have grown. This psychotherapeutic tradition is addressed primarily to the human constitutional (body structure) and genetic type of the patient and helps a person with the specific traits of personality to find their place among other people. Clinical psychotherapy found its vivid expression in the works of Ernst Kretschmer, who, in my opinion, is a figure, at least equal to Freud.

We can also talk about another way of psychotherapy. In contrast to the psychodynamic and clinical areas, here the main interest is focused on the external elements (in relation to the basic constitutional and genetic personality type) – on how specifically the experience is expressed, and, in particular, on how much energy the body spends on its «feeding’. This approach can be called psychoenergetic, to which somatopsychotherapy belongs.

I’m not interested in “what’ and “how’ – I’m interested in’ how much’

In a simplified form, the position of a somatopsychotherapist can be stated as the following: “I am not interested in what the patients thinks or how they do it, I am interested in how much they think about it, how much energy they give it. If it is more than the “normal’ it is a disease, if it is less than “normal’ it is also the disease.

If, after a trip to England, they think they ate beef infected with «mad cow disease’ (BSE), I am not going to talk to them about the incubation period of variant CJD. I am also not going to dissuade this person that they caught a terrible disease and now they are going to die. (Especially since I do not know if they are infected or not.) I am interested only in one thing: how long are they going to think about it? Now they dedicate to this almost 24 hours a day, spending 99% of their vitality. Is that what it needs, or can it be less?

How can I make a person who has lost sleep and peace think about the amount of energy spent on the experience (and not on solving problems)? Here is the answer: through simple questions about what they experience «at body level’ because of what has happened.

The soul has a body

As it turned out, two simple questions “Where? ‘and “What ‘set in relation to experiences, lead to the fact that… the soul reveals its body! The feelings are “depicted’, and the soul, just as light, reveals its particle nature along with the wave.

The name of the method – ’somatopsychotherapy’ – emphasizes its specific feature. It works with the soul as with the body (or with the body as with the soul). However, this body is not physical, «medical’, but the body of consciousness, the «psychological’ one.

Somatopsychotherapy (SPT) (with the emphasis on the first syllable, from the Greek «Somos’ – «body’) – SPT-stands for: «Work with somatized equivalents of mental experiences¹. Fortunately, this formulation intrigued not only my children, who used to ask asked me: «How are your «somatized equivalents’ doing there?» My colleagues’ interest in my work encouraged me to think about writing the book that you are holding in your hands now.

“Filling’ of the body of consciousness

As a result of the catalysis of bodily sensations, the consciousness-body shows itself as “filled’ or, rather, realized as a set of “mental objects’. They can be “good’, such as love, joy, etc., or “bad’, such as hatred, fear, etc.

If we consider a person in this paradigm, it turns out that by the time of the meeting with the therapist, they (as a result of the elections, consciously or unconsciously made by the body earlier) have transformed into light, warmth, space, lightness – and then there is no need for a therapist, or on the contrary – into the darkness, heat, tightness, heaviness in places of linkage or accumulation of energy (substance «heat – heaviness’, as it is called in SPT), and at the same time – into dullness, cold, «aridity’, numbness in the devastated areas. In this case we have all the indications for therapy.

The “backward’ therapy

The therapy based on body sensations moves in the opposite direction to what has been developed in most modern psychotherapeutic approaches. I call them “therapy forward,” which is aimed at the release of a once pent-up emotional charge. Through the study of resistance, the dynamics of expression is encouraged. The opposite “dynamics of the suppression’ has also got some supporters. What, if not suppression, is therapy by “coding’ or “torpedo’ in case of alcoholism?

True and false alternatives

During exams in medical school, students are often asked a provocative question: are lobar pneumonia-rale in the lungs fine or large bubbled? The correct answer does not imply either the first or the second options, because there is no rale in the lungs in case of lobar pneumonia.

So, to encourage expression or suppression of emotions seems to me the same false alternative. There is at least one other way out – to return to the original situation… through the entrance. Emotional life is not a one-way street where traffic jams occur. It resembles rather a flat surface with a ball on it, which can lurch in any direction. The ball can roll back just as it can move forward until it falls from the surface. Instead of building barriers to the movement of the ball, you can change the angle of inclination… it is possible to simply calm down, refusing both expression and suppression of emotions. It is not the same as giving emotions a way out. That means getting them back in.

Perhaps a comparison to removing the detonator from the bomb would help to explain what I mean. The disposal of an explosive projectile would mean refusing both to detonate it and to conceal it. When it is dismantled, it is possible to think of the new use of the potential energy stored in it. The same uranium that threatened to destroy all life can become a filling for the reactor of a power plant, supplying both light and heat.

Thus, we can give forces the ability to stop completely, go back, and then look for a new solution to the problem, being in the new state. This is the way to discharge both dynamics.

The psychostatic paradigm

Stopping consciousness and turning it into a body is a method, that opens up new opportunities in psychotherapy. I have called it psychostatic, after correlating with better known psychodynamic principle.

The above-mentioned principle «where’ involves searching in space for the affects as charged objectified (somatized) structures and allows us to speak about «topographic (or topical) psychology’ (perpendicular to «chronological’ – in particular, transpersonal). In general, this method can be called «Topographic psychology and the psychostatic paradigm in psychotherapy.»

Therapy «backwards’, is the technique of «zeroing the patient’s condition’, calm «without annexation and indemnity’ – these are some of the names of the therapeutic part of the work.

This method is a worthy alternative to the existing methods of restoring the psychophysical balance of a person.

An eye view can melt the stones

Instead of trying to revive the almost dead (“petrified’) feelings, somatopsychotherapy offers to “dissolve’ them, to let them “die’ completely. Though, not to disappear, but to be reborn in a new capacity.

One of the discoveries of somatopsychotherapy, in my opinion, is the fact that, if a person refrains from hysterical, hypochondriac, phobic and other pathological ways of responding to the fact of the awareness of the «stones’ within them, and retains a calm, judicious attitude to conscious, this suffering person becomes a winner, they get their power back, reborn like a Phoenix from the ashes. The task of the somatopsychotherapist is to help the patient create and maintain a working tone in relation to these phenomena, without unnecessary affectation, but by understanding the significance of what is happening.

The patients can melt the stones with their own eyes, and it will not be just a «game of imagination’, but a real change to: 1) the structure of their consciousness; 2) the state of their body.

Working with sensations as a method of psychotherapy is highly effective and fast-acting. It can change the patient’s condition radically and do it without the phantasmagoric external manifestations inherent in some known types of therapy.

For my last preliminary remark, my own experience and communication with colleagues brings me to the idea that along with the division into schools in the world practice, there is a very simple division into «fast’ and «slow’ or «short’ and «long’ types of psychotherapy.

Experience makes us accept the fact that all forms of work are important. The fact that you can work with a patient for five, ten minutes, or even a year, or two, or more, and all this will be normal psychotherapy, does not seem to be a paradox.

So-called classical schools, such as clinical psychotherapy or psychoanalysis, or younger schools like gestalt therapy, tend to work over the long time. Among «short-term’ schools, there are representatives of neuro-linguistic programming, next to them, perhaps, eriksonians and some other supporters of empirical, short-term, intensive psychotherapy.

This method also draws from the intensive and short-term schools. It is good for working through traumas. However, it is as thorough as the therapies of the first «classic’ group.

1500 patients

From my point of view, this study takes into consideration the most important issues of psychotherapy.

How to bring the patients to an understanding of their inner state?

How to change that inner state for better?

How to get a sustainable result?

After 15 years of research, this method has been formed by the process of solving psychological and psychosomatic problems of more than 1500 people during 3—5 sessions of one hour with each of them.

1. Modern directions of psychotherapy and their clinical application. Materials of the I All-Russian conference on psychotherapy. – Moscow: Institute of psychotherapy, 1996, 196 p.