Write-up – Ruella Frank

How does early development effect the embodiment of the clinical encounter?

Ruella Frank, PhD

I practice as a gestalt psychotherapist; my practice is phenomenological and aesthetic. I began my training in 1982. Before that time, I studied infant movements patterns for some years. I learned the work of  Bonnie Bainbridge-Cohen, who worked with developmentally delayed infant. She believed that how babies moved told you something about the organizing of their brain. I also studied the work of Judith Kestenberg, psychoanalyst and psychiatrist, and a student of Laban movement theory. Dr. Kestenberg believed that how a child moved told you something about they organized their feelings and thoughtsThis is the background I brought to my gestalt studies. I was hoping to integrate early movements into the clinical encounter.

Over time, and inspired by these movement educators and with the support of Laura Perls, my teacher and one of the founders of Gestalt therapy, I organized a non-verbal vocabulary based on what I refer to as the 6 primary and fundamental micro-movements that support all possibilities for contacting. Contacting is an interaction and how one meets the other — person or object, event, even our thoughts. I observed these movements emerging in the first year and continuing throughout life, and attributed a psychological function to each one. These six micromovements are never isolated, rather they operate in combination with one another.

The Six Fundamental Movements are:  being with—the capacity to be with oneself and another; pushing against—separating from while including the other; reaching for—that which is desired, needed, what one is curious about; grasping onto—what one has reached for to see how it fits the desire or need—and if so; Pulling toward to integrate and assimilate the novelty of the WE from the I/You/It of the situation. This new information that we pull toward us is the transforming of the familiar into the new. Release from—the task completes itself, the gestalt closes. What we gained is now sedimented and will serve as background for subsequent experiences.

Every micromovement is followed by a preposition.  There is always a noun that follows each verb. There is always the other that we are moving toward or away from in our attempt to expand ourselves and become more than we are. This is the process of growth and change.

Observing emerging movements in the earliest dyad and in the unfolding relation between therapist and patient, I realized a functional similarity between the two. From these foundational movement patterns, meaning is co-created within the situation. Meaning is emergent of a moving relational field. As we move, there are concomitant qualities to our movement that form our unique affective experience. We move and sense how we move as we move. Movement is our primary and most elementary and direct interaction with others. Our moving-sensing body, or Lived Body, as Husserl, referred to it, is our unique way of being in the world.

Understanding how meaning is made from these primordial micromovements can help the practitioner better attune to the forming of experience in the relational field. To see more clearly is to feel more clearly and to feel more clearly is to see more clearly. Understanding movement, we see the forming of form and can move from content (the form) to process (the forming). Simply said, following movement patterns expressed through every gesture, our own and those of our patient, we learn how we c0-organize the situation we are living.

Case vignette:

James is middle aged, well over six feet, very broad, and although heavy, solidly built. He walks into the session with an upright spine although his head is cast downward. Once seated, he rarely moves and hardly breathes. His vocal tone is steady, even and does not discernibly  change. He fits snugly into my big green chair, his fingers draped on the arms rests and his hands grasping the chair’s edges, fingers cast downward.

James and I have worked together for some time. Much of our session, we speak of films or books or even cooking on occasion. Through our chatting, James realizes that I am interested in and curious about him, which builds the ground of our relationship.

When our conversations become somewhat intimate, James responds by lifting both fingers off the chair’s edges.

In my sub-verbal vocabulary, the primordial movement pushing-against is in foreground. The psychological function of Pushing-against is about differentiation defined as the individual attempts to separate from while including the other in experience. Working in tandem with the other five micromovements, pushing-against is how we effort our aggressing into the environment. In gestalt theory, we see aggression as everything the organism does to contact its environment in a form that is appropriate to the ever-changing field. And appropriate is not delineated by some social norm, but whatever is fitting for person within the situation and that brings fulfillment of one’s desires. Within the baby-caregiver field, it can appear evident as the baby pushes against the caregiver to find more space, or say no to whatever it is offered; separating from while inclucing the other gives a clarity to the difference between one and the other. The pushing-against signal is a necessary expression and articulation of intention. With James, the pushing-against has emerged into the foreground which the other five micro-movements that compose this experience remain as background support.

When I observe James inhibited pushing against gesture, I take it seriously. I feel the holding of my breath and the muscles of my chest are held more firmly. This is not my experience alone, but an experience of what is emerging between us – a movement of the field. James’ pattern of pushing against me lacks enough effort for his intention to accomplish the task at hand. I recognize his aborted attempt as he tries to do something in terms of differentiating while still including me in the experience. I am sensitive to how he signals me even though it is vague. I wonder if it is  vague for James as well.

I tell James that perhaps we have finished with this topic for now, and attempt to gracefully move to something else. Although some gestures can be brought to the attention of the patient, in this scenario, James’ anxiety would magnify had I inquired about his gesture.

The diminished excitement of his persona was an attempt to maintain and omnipotent control over his lived body through vigilant control of his expressions and vocal intonations. These were his gestures to the world.

About six months later, James came into my office, sat down, placed his head in his hands, and cried deeply. His mother had just died. We had developed enough support in the relational field for him to express himself is such an authentic way. From that session onwards, James was more able to tolerate some of his discomfort as he revealed as much about himself as he could, and could find the words that he wasn’t ready to do more. His capacity to push-against me was enhanced.