Depth-psychologically based body psychotherapy (Downing)

Domain IV · Body-oriented psychotherapy · George Downing · 1995

What it is

George Downing's body psychotherapy is a way of weaving short, focused body work into an ordinary talk-based, depth-psychological (psychodynamic) therapy. The book's title, "body and word", sums it up. The publisher's description says the book combines body-centred work with a purely verbal…

Format

• Format. Individual outpatient therapy. The therapy follows the length of the host psychodynamic treatment (short-term to long-term). Body interventions usually last a few minutes up to a large part of a session. They are done mostly sitting or standing in the ordinary consulting room; mats,…
• Session count: about 1–5 sessions.

Who practises it, and how they are trained or regulated

• The sources give no formal phase model for Downing's body work. It is used as a set of in-session moves inside a longer psychodynamic (or cognitive-behavioural) therapy, not as a staged programme. Geuter says the 1996 book sets out "Grundzüge einer Lehre der Technik" (an outline of a theory of technique), but the publisher's sample gives no details. Downing's website, the publisher descriptions, Reck's slides and…
• End criteria: symptom and relationship goals of the host therapy are reached, and the client can use body awareness for self-regulation on their own.
• Version followed: George Downing's approach, which his own website calls Body-Focused Therapy (BFT), as set out in Körper und Wort in der Psychotherapie: Leitlinien für die Praxis (Kösel, 1996; first published in Italian as Il corpo e la parola, Astrolabio-Ubaldini, 1995), reconstructed from the German-language secondary literature that teaches and applies it (Langlotz-Weis 2017, 2019; Geuter 2015; Sassenfeld 2011;…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Signs it is working: slower breathing, warmth returning, the client able to make eye contact and speak in full sentences. If calming does not work, see 5.3.
• The feeling becoming a manageable signal, which shows modulation is working. Escalation, or shame afterwards, means you should regulate, normalise and debrief.
• Intrusive images of abusive touch. If they appear, stop, ground and choose a neutral source. Signs it is working: the soothing transfers into everyday self-calming.
• VIT needs separate training; Downing's website lists a VIT certification, and LMU Munich offers a basic VIT certificate within its early-childhood training. Notice and use your own…
• Signs it is working: a felt "yes, that's it", a shift in breath or posture. Signs of a problem: purely cognitive answers to body questions, or the client going along with your words.

Problems the guide addresses

• "I don't feel anything" (low body awareness, alexithymia)
• Resistance to body work ("this is silly", shame, refusal)
• Overwhelm, flooding, dissociation
• Non-adherence to everyday practice
• Ruptures, especially around touch and enactment
• Screening and contraindications for activating work
• Modality-specific difficulties

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.