Affect-focused body psychotherapy

Domain IV · Body-oriented psychotherapy · Adrienne Levy Berg · 2009 · Sweden

What it is

What it is: an individual, psychodynamically informed treatment that combines hands-on and movement-based body work with structured exploration of affects. It rests on two "cornerstones": NPMP, which treats the body as a functional unit and sees breathing, muscle tension and posture as tied to…

Format

• ABP has no published session-by-session protocol. The trial gives the dose (weekly for about one year), and the sources describe a sequence of emphases rather than fixed phases. The phases below put that sequence in order; the phase labels are, and their content is sourced.
• Format. Individual sessions, weekly for one year in the GAD trial. Earlier PBT/NPMP studies with pain patients averaged about 33 treatments, and PBT clinicians expected 20–40 treatments even in milder cases before change was stable. Session length for ABP itself is not reported. In the related NPMP…

Who practises it, and how they are trained or regulated

• Who delivers it: in the trial, four clinicians who had recently completed PBT training; the author was one of them. In Sweden PBT was taught from 1990 as a 40-credit postgraduate course at Karolinska Institutet. Hands-on work requires specific training and supervision, and you should check that your licence and jurisdiction allow therapeutic touch and massage. In Scandinavia this work grew out of physiotherapy.

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 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?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• 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

• Flooding. Return to stability (5.2).
• Forcing or performing; ask for less effort.
• Projecting your own state onto the patient. Hold guesses lightly.
• Shifting to generalities ("I'm always like this"). Gently return to the scene.
• A spontaneous deeper in-breath and longer out-breath, which show the dose fits.

Problems the guide addresses

• Shame and loss of control during body work
• Overwhelm and too-rapid opening
• Dissociation, freezing or going limp under touch
• Stuck: talk without body contact, or body work without affect
• Resistance and defences
• Shame or regret after emotional expression
• Patient does not want touch, or wants talk only
• Non-adherence to self-practice
• Contraindications and screening (body work)
• Ruptures in the relationship

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.