Somatopsychodynamic vegetotherapy

1. Introduction

Version followed: Federico Navarro's characteranalytic vegetotherapy (his "somatopsychodynamics" systematisation), with its top-down sequence of the seven levels, as his Spanish (ES.TE.R, Valencia: Serrano, Vílchez, Redón), Italian (SIAR; Ferri and associates) and Brazilian (Centro Reichiano, Curitiba: Volpi) successors report it. Ferri's 1983 re-ordering of the levels and his acting timings are flagged where used. Navarro's own manuals (Metodologia della vegetoterapia caratteroanalitica; La somatopsicodinamica) are not drawn on here. Supported from school and journal sources: session length, frequency and overall duration (ES.TE.R); the ES.TE.R position on touch and massage; ES.TE.R training requirements; the published range of acting durations; named actings for the ocular and oral levels (SIAR case report, Italian and Brazilian sources); and example actings for the neck and arms (Volpi 2026). Still [uncertain]: Navarro's complete set of actings for each level (above all diaphragm, abdomen and pelvis), his own timings, and any formal ending procedure. No source describes these.

What it is. "Somatopsychodynamic vegetotherapy" is a label used for this approach. In the sources, the clinical method is called characteranalytic vegetotherapy (vegetoterapia carattero-analitica / caracteroanalítica). Somatopsicodinámica is the title of Navarro's book on a Reichian systematics of pathology and clinical medicine. Navarro was an Italian physician who trained in Ola Raknes's Reichian lineage and died in October 2002. He systematised Reich's vegetotherapy into a sequence of body "actings" for each of Reich's seven body levels, and Raknes endorsed this in 1974 [source: Serrano 2004; Carmo & Ribeiro 2025]. His method is taught in Spain through the Escuela Española de Terapia Reichiana (ES.TE.R), which also developed a brief, focal version called Psicoterapia Breve Caracteroanalítica (PBC). In Italy and Brazil it continues as "contemporary Reichian analysis" (Ferri) [source: Serrano 2004; Infocop 2008; Carmo & Ribeiro 2025].

How change happens (the school's model). Reich's and Navarro's theory holds that early relational experiences leave defensive patterns, a "character armour", in both character traits and chronic muscular and neurovegetative patterns. These patterns are layered over seven body levels that follow the order of development, from the eyes ("telereceptors") to the pelvis [source: Redón; Carmo & Ribeiro 2025]. Change is meant to come from three things. First, short, simple, intentional neuromuscular movements called actings provoke "neurovegetative, emotional and muscular reactions" (ab-reactions). Second, these reactions are put into words and analysed within the transference relationship. Third, character analysis loosens the defences that the reactions expose. The stated aim is to move from a defensive "caracterialidad" towards what the school calls a mature "genital" character [source: Serrano 2004; Redón; Rocha et al. 2020]. Navarro held that the basic emotion behind all pathology is fear [source: Serrano 2004]. Energy terms used below, such as bioenergetic pulsation and "energy flow", are Reich's and Navarro's theory, not established physiology.

2. Framework

Assessment: Initial and Differential Structural Diagnosis (D.I.D.E.) [source: Redón; Infocop 2008; Serrano 1990 cited]

The assessment covers: constitutional predisposition; "bioenergetic metabolism"; object relations and character traits; muscular blocks; neurovegetative functioning; and the person's current life situation.
It allocates the client to one of three structures, and treatment is planned differently for each:
- Psychotic ("mimetic"): a weak energetic core, almost no armour, shallow breathing, low muscle tone, and ocular and diaphragmatic blocks.
- Borderline ("nuclear"): energy collected in some zones, generalised tension, and strong ocular and oral blocks.
- Neurotic ("adaptive"): most tension in the cervical, diaphragmatic and pelvic levels, with the Oedipal stage as the key period.
Diagnosis is never made from the body alone. Body reading is set against the history [source: Rocha et al. 2020].

Choice of format

Full characteranalytic vegetotherapy: long-term depth therapy. ES.TE.R gives sessions of 45 or 90 minutes, about twice a week (roughly eight a month), averaging some 250 sessions of 45 minutes over about 2.5–3 years. Group therapy may be combined with the individual work at a suitable point [source: Vílchez & Serrano 2016]. Serrano elsewhere says the setting needs "several hundred hours" [source: Serrano 2011, ch. 2]. Navarro also offered former trainees open-ended "maintenance" ("ad vitam") sessions [source: Serrano 2004].
PBC (ES.TE.R brief version): about 20 sessions, weekly, over roughly six months. In phase 3 (months 4–6) individual sessions are combined with group sessions. The work targets a single focus: a character trait weakened by current stressors. PBC is used for every structure except psychotic ones and is not used in crisis work. The goals of phases 1 and 2 were not detailed in the source [source: Infocop 2008] [uncertain].
Serrano also names PBC as the alternative when diagnostic or institutional conditions rule out full vegetotherapy [source: Redón].

Phases of the full therapy (sources give a two-stage rhythm, not formal phases) [source: Redón; Carmo & Ribeiro 2025]

Assessment and alliance: D.I.D.E., body reading, and character analysis of the presenting defences.
Level-by-level acting work: Navarro's sequence runs from the top of the body downwards: (1) eyes, ears and nose → (2) mouth → (3) neck → (4) thorax, including the arms → (5) diaphragm → (6) abdomen → (7) pelvis, including the legs. Ferri's 1983 order is 6 → 2 → 4 → 3 → 5 → 7 → 1. Within each session there are two moments: emotional expression of what was repressed (the acting), then verbal elaboration.
Integration and ending: none of the ES.TE.R, SIAR or Centro Reichiano sources describes a formal ending procedure [uncertain]. ES.TE.R gives the goal of full vegetotherapy as dissolving the armour towards a "genital" character, whereas PBC aims at easing symptoms [source: Amenábar, presentation of Serrano 2020]. A practical ending would review which levels' actings have become reliably pleasurable, reduce session frequency step by step, and agree follow-up [synthesis].

Session format [source: Carmo & Ribeiro 2025; Rocha et al. 2020]

The client lies on their back on a wide couch, eyes open, knees bent and feet flat on the surface. ES.TE.R describes minimal clothing or a swimsuit, with the therapist sitting beside the couch, observing and accompanying [source: Vílchez & Serrano 2016]. Comfortable clothing is a reasonable adaptation [synthesis].
The sources give different acting durations. ES.TE.R says only that actings are done "durante unos minutos" (for a few minutes) [source: Vílchez & Serrano 2016]. Ferri gives about 8–15 minutes, which he compares to a dose [source: Carmo & Ribeiro 2025]. Volpi gives 15–25 minutes for Navarro's traditional actings and 3–5 minutes for his own brief-focal version [source: Volpi 2026]. Navarro's own figures are not drawn on here [uncertain]. Follow the figure of the lineage you trained in.
The same acting may be repeated over many sessions, for at least six months in Ferri's account. Navarro stressed strict respect for the timing and frequency of actings.

Criteria for moving on [source: Carmo & Ribeiro 2025; Rocha et al. 2020]

An acting often feels unpleasant or neutral at first. It counts as "unblocked" when it becomes pleasurable and stays pleasurable across sessions, which is read as a change of trait rather than of state.
Work proceeds downwards. Navarro warned that steering "energy" upward risks bringing out a psychotic core in an "uncontrolled crisis". Structures with a psychotic core need different techniques from the segmental work used for neurotic structures.
Not drawn on: precise rules for when to move to the next level. A cautious working rule is: move on once the current level's acting is reliably pleasurable, the material it raises has been put into words, and the client stays regulated between sessions [synthesis].

3. Guiding principles

With the person, not on the person ("con la persona y no sobre la persona") [source: Redón]. In practice, the client does the actings and touch stays minimal.
Actings are not gymnastics: "simple, intentional and active muscular movements" [source: Carmo & Ribeiro 2025]. Insist on intention and attention, not mechanical repetition.
Homeobiotic: actings resemble spontaneous emotional expression and are paced to the client's rhythm [source: Redón]. Never force speed or intensity.
A therapy, not an emotional-release technique [source: Serrano 2004]. Discharge on its own is not the goal; elaboration and character change are.
Structure decides technique [source: Rocha et al. 2020; Infocop 2008]. Do the D.I.D.E. before choosing any acting, and do not use segmental release work with psychotic structures.
Top-down, following development [source: Carmo & Ribeiro 2025; Redón]. Start at the eyes (or follow Ferri's order, if that is your training), and never push upward.
Timing as dosage [source: Carmo & Ribeiro 2025]. Keep acting duration and repetition steady, and do not escalate in order to "get results".
Feel first, think after [source: Carmo & Ribeiro 2025; Rocha et al. 2020]. The client does not talk during an acting, and you ask for words only afterwards.
Character analysis of resistance (Reich 1933) [source: Redón]. Treat a resistance shown in an acting as character material to analyse, not to override.
Contact and empathy: Navarro, following Raknes, asked the therapist to keep "contact" and to "open the field" [source: Serrano 2004]. Stay present and attuned throughout the acting, not only in the talk.
Countertransference hygiene: you can only predict the effect of an acting if your own neurotic countertransference is not interfering [source: Redón]. This requires personal therapy and supervision.
Fear is primary [source: Serrano 2004]. Expect fear beneath anger, rigidity or withdrawal, and make safety the first task.
Pleasure as the marker of change [source: Carmo & Ribeiro 2025]. Track whether the acting becomes pleasurable and stays so.
For borderline structures, inclusion "at a fair distance" with firm limits [source: Ferri & Barbato 2022]. Hold a predictable frame, and keep body work gentle and "respectful of her limits".
Theory is theory: orgone, "energy" and "segments" are the school's own model. Never treat the method as a treatment for physical disease, whatever Navarro's views on "biopathies" (see 4.14) [synthesis].

4. Intervention inventory

Coverage note. This inventory covers every procedure described in the sources used. Navarro's complete list of actings is in his Metodologia, which is not drawn on here. This revision adds the level-specific actings that school and journal sources name: 4.5 (ocular), 4.5a (oral) and 4.5b (neck and arms). For the remaining levels, 4.11 gives targets only [uncertain]. Do not improvise level-specific actings beyond what is described here. Learn them in ES.TE.R, SIAR or Centro Reichiano training; these schools state that the method is learned through personal therapy and supervision, not from books [source: ES.TE.R 2023; Volpi 2022]. Touch: ES.TE.R avoids direct contact with the patient's body (see 4.7), but some procedures below involve touch in other lineages. Touch requires specific training and supervision, and you must check what your licence and jurisdiction allow.

4.1 Initial and Differential Structural Diagnosis (D.I.D.E.) and body reading

Purpose / when: at intake, and again whenever the client's response to body work surprises you. It decides between full vegetotherapy, PBC or another treatment, and which levels it is safe to work [source: Redón; Infocop 2008].
Steps:
1. Take a developmental and relational history, with particular attention to fear and to how early bonds were laid down at each developmental level [source: Carmo & Ribeiro 2025].
2. Observe the clothed body at rest, sitting and lying. Note breathing (depth, and whether it is in the chest or the abdomen), muscle tone (high or low), the eyes (how much contact, how mobile, what quality of gaze), the jaw and mouth, the neck, the diaphragm, and the pelvis. Note also how the client settles on the couch [source: Rocha et al. 2020; Ferri & Barbato 2022].
3. Map what you see onto the six D.I.D.E. areas and assign a provisional structure: psychotic, borderline or neurotic.
4. Check the body reading against the history; never diagnose from the body alone [source: Rocha et al. 2020].
5. Screen for contraindications to breath and acting work (see 4.3) [synthesis].
Example language (illustrative): "Before we do any body work, I'd like to understand how you're put together: your history, how you breathe, where you hold. Some of it I'll just observe while we talk."
Watch for: shallow breathing with low tone and a vacant or fearful gaze, which suggests a psychotic structure, where segmental release work is not used. Strong ocular and oral blocks with generalised tension suggest a borderline structure [source: Redón].

4.2 Character analysis (verbal)

Purpose / when: throughout the therapy. It softens resistances by analysing how the client defends, not only what they say. This is Reich's 1933 method, which Navarro kept [source: Redón; Serrano 2004].
Steps:
1. Identify a recurring defensive manner: tone, posture, politeness, vagueness, or control of the session.
2. Describe it neutrally and repeatedly when it appears, before interpreting content.
3. Link it to the body pattern you observed (for example, a set jaw while the client speaks of anger) and, later, to its history.
4. Use free association and the transference alongside the body work [source: Infocop 2008].
Example language (illustrative): "I notice that each time we come near your father, you smile and your breathing stops. Can we stay with that for a moment?"
Watch for: relief or curiosity, which suggests the defence is loosening, versus compliance or growing rigidity, which suggests it is being reinforced. In the latter case slow down and analyse the compliance itself.

4.3 Basic couch position and breath awareness (the frame for every acting)

Purpose / when: the starting position for all actings, and on its own as an early, low-intensity way of making contact with the body [source: Rocha et al. 2020; Carmo & Ribeiro 2025].
Steps:
1. The client lies on their back on a wide couch, eyes open, knees bent and feet flat on the surface. ES.TE.R describes minimal clothing or a swimsuit, with the therapist sitting beside the couch [source: Vílchez & Serrano 2016]. Ferri's tradition cites joint angles of about 45° [source: Carmo & Ribeiro 2025]. Comfortable clothes are an acceptable adaptation [synthesis].
2. Notice how the client settles, because it is diagnostic material [source: Rocha et al. 2020].
3. Ask for deeper breathing while the client attends to sensation, without talking [source: Rocha et al. 2020].
4. Observe the wave of breath. The school reads a gradual rise through thorax, abdomen and pelvis, with the shoulders letting go and the head tilting slightly back, as the "orgasm reflex" described by Reich [source: Carmo & Ribeiro 2025]. Serrano summarises Reich's late phase as deep breathing for 5–10 minutes while the shoulders drop and the pelvis rises. He stresses that the reflex is only a neurovegetative signal, not a sign of health [source: Serrano 2011, ch. 2]. Treat it as the school's interpretation, not a target to push for.
5. Close with ordinary breathing, sitting up slowly, and a verbal check (see 4.9).
Example language (illustrative): "Let your knees stay bent, feet on the couch. Breathe a little more fully than usual, without forcing. No need to talk; just notice what happens."
Watch for: dizziness, tingling or cramping in the hands, or rising panic. These suggest over-breathing: return to normal breathing, have the client sit up, and orient them to the room [synthesis].
Contraindications and screening for breath-deepening work [synthesis unless stated]: psychotic structure or psychotic history (Navarro: risk of an "uncontrolled crisis" [source: Rocha et al. 2020]); severe dissociation; active suicidality; recent trauma not yet stabilised; pregnancy; cardiovascular or respiratory illness; epilepsy; recent injury or surgery. For borderline structures, keep the work gentle and stop when signs of decompensation appear [source: Ferri & Barbato 2022].

4.4 Running an acting (generic protocol)

Purpose / when: the core intervention. An acting is a short, simple, intentional movement or activation of one body level, repeated within a session and across sessions, to evoke the neurovegetative and emotional reaction held at that level [source: Serrano 2004; Carmo & Ribeiro 2025].
Steps:
1. Choose the acting from the level you are working on (Navarro's order runs 1 to 7, top-down; see 4.5–4.5b and 4.11). Volpi distinguishes two kinds. In a fixed-position acting, the client holds a posture that activates a muscle group, such as a fixed gaze, the neck held off the couch, or the arms raised. In a rhythmic acting, the client repeats a movement, such as eye movements, neck rotation, or the arms striking the couch [source: Volpi 2026].
2. Explain the acting and its purpose, demonstrate it if needed, and agree a stop signal [synthesis].
3. The client lies in the basic position (4.3) and performs the acting with attention and intention, not mechanically, while breathing deeply and not talking [source: Carmo & Ribeiro 2025; Rocha et al. 2020].
4. The client repeats the acting at their own rhythm ("a su manera y con su ritmo") [source: Vílchez & Serrano 2016]. Keep to your lineage's duration: "a few minutes" for ES.TE.R, about 8–15 minutes for Ferri, or 15–25 minutes for Navarro's traditional actings as Volpi reports them [source: Vílchez & Serrano 2016; Carmo & Ribeiro 2025; Volpi 2026]. Start at the short end with a new client [synthesis].
5. You observe breath, colour, tremor, vocalisation, eye contact and emotional signs, and stay in empathic "contact" [source: Serrano 2004].
6. If an emotion breaks through, let it run its course without amplifying it. You may offer minimal contact (4.8).
7. End the acting, give a short period of rest with ordinary breathing, then move to verbal elaboration (4.9).
8. Repeat the same acting in later sessions until it becomes pleasurable and stays so [source: Carmo & Ribeiro 2025].
Example language (illustrative): "We'll do this movement slowly for about ten minutes. Keep breathing, keep your attention in the sensation, and don't try to make anything happen. Raise your hand if you want to stop."
Watch for: Signs it is working are that the acting moves from unpleasant or neutral towards pleasure, the breath deepens spontaneously, and emotion appears that can then be put into words. Warning signs are mechanical performing, numbing, panic, or a sudden flood of affect with loss of orientation. In those cases stop, ground the client, and reconsider the structure diagnosis (see section 5).

4.5 Ocular-level actings with a light (level 1)

Purpose / when: the first level in Navarro's top-down order, worked first in the full method. It is used to establish contact, a sense of boundary and reality-testing, especially in borderline structures where an ocular block is prominent [source: Ferri & Barbato 2022; Redón]. The SIAR model links the ocular actings to the oro-labial developmental phase [source: Lelii 2024]. Navarro's full list of ocular actings is not drawn on here [uncertain]. The actings below are the ones named in Italian (SIAR) and Brazilian sources.
Equipment: a small pen-light held by the therapist [source: Lelii 2024; Volpi 2022].
Actings named in the sources:
- Convergence on an approaching and receding point: the client focuses both eyes on a point that is brought closer and moved away, converging on it [source: Psicologhe di famiglia; Lelii 2024]. In Lelii's case the light starts about 20 cm from the face and moves down towards the glabella (between the eyebrows). The therapist notes where the eyes stop converging or the image doubles [source: Lelii 2024].
- Lateral arc: starting at glabella height, the therapist moves the light rhythmically in an arc along the horizon, from one side to the other, and the eyes follow it. Lelii places this at the transition to the next developmental field [source: Lelii 2024].
- "Naso cielo": the eyes converge towards the bridge of the nose while the therapist holds the light still at about 30–40 cm, as a "stable, present" object [source: Lelii 2024].
- Fixed gaze on a still point: a fixed-position acting [source: Volpi 2026]. The client keeps the gaze on a still light while breathing and attends to sensations around the eyes and in the chest [source: Ferri & Barbato 2022].
- Grimaces after eye work: one Brazilian teaching presentation says that eye work should always be followed by facial grimaces ("caretas") to connect the first and second levels [source: Medeiros, Prezi] [uncertain: single, non-peer-reviewed source].
Steps:
1. Put the client in the basic position (4.3), eyes open. Explain the acting and agree a stop signal [synthesis].
2. Use one acting at a time, at the client's rhythm, within your lineage's time frame (4.4). Keep it shorter at first for fragile clients [synthesis].
3. Watch the quality of the gaze: empty, avoidant, suspicious or luminous. Ferri and Barbato use these terms as questions to hold in mind, not as findings [source: Ferri & Barbato 2022]. Also note where convergence fails or the image doubles [source: Lelii 2024].
4. Close by letting the eyes rest closed, then reorient the client to the room by naming objects. Then elaborate verbally (4.9) [synthesis].
5. Titrate. In Lelii's case, a combined oral variant proved too much for the client, so the therapist dropped it and kept the simpler ocular acting [source: Lelii 2024].
Adapting for a client without sight: Volpi describes the therapist narrating where the light is, the client placing their hands on the pen-light to locate it, and the client imagining the light entering the eyes and moving through the body [source: Volpi 2022].
Example language (illustrative): "Follow the light with both eyes as it comes closer... and as it moves away. Keep breathing. If it doubles, just notice where."
Watch for: signs it is working are emotion that "resonates" in the chest, followed by fear and abandonment material that can be put into words [source: Ferri & Barbato 2022], or laughter followed by thoughts or memories [source: Lelii 2024]. Warning signs are dissociation, a glazed gaze, headache, eye strain, or a flare-up of symptoms after a new variant, as in Lelii's case [source: Lelii 2024]. Shorten or stop, and keep the work "gentle" [source: Ferri & Barbato 2022]. Check for photosensitive epilepsy and eye conditions before light work [synthesis].

4.5a Oral-level actings: sucking and biting (level 2)

Purpose / when: the second level, which carries the oral relation from feeding onwards. Strong oral blocks are prominent in borderline structures [source: Redón; Ferri & Barbato 2022]. Sources name two basic oral movements, sucking and biting [source: Psicologhe di famiglia]. An unsigned Brazilian site adds shouting [source: WilhelmReich.com.br] [uncertain]. In the SIAR model, a relational variant called the "distancing" sucking acting ("movimento di suzione – distanziante") belongs to the first field of level 2. It can touch depressive feelings linked to the client's feeding history [source: Lelii 2024].
Steps: no source gives the movement detail, the timing, or any object used, because Navarro's manual is not drawn on [uncertain]. Applied within the generic frame of 4.4, the steps would be [synthesis]:
1. Put the client in the basic position.
2. The client makes a slow, repeated sucking movement of the lips, or a biting movement of the jaw, at their own rhythm, breathing and not talking.
3. Rest, then elaborate verbally (4.9).
4. If any object is used for sucking or biting, it must be single-use or the client's own.
Example language (illustrative): "Make a slow sucking movement with your lips, at your own pace, and notice what comes with it."
Watch for: in Lelii's case, symptoms flared up after a sucking variant was combined with an ocular acting, and the therapist withdrew it as too much [source: Lelii 2024]. Expect longing or depressive material, and slow down if it floods the client. If the client has jaw pain or a temporomandibular joint problem, reduce the intensity of biting or leave it out [synthesis].

4.5b Neck, thorax and arm actings (levels 3–4)

Purpose / when: levels 3 and 4. Cervical tension is typical of neurotic structures [source: Redón], and the chest is where emotion "resonates" [source: Ferri & Barbato 2022].
Actings named: Volpi gives four examples [source: Volpi 2026]:
- a fixed-position acting with the neck held up off the couch;
- a rhythmic acting of neck rotation;
- a fixed position with the arms raised;
- a rhythmic acting with the arms striking the couch.
An unsigned site adds reaching and hugging movements of the arms, and lists the gag reflex as a focus at the cervical level [source: WilhelmReich.com.br] [uncertain]. That site gives no procedure for any of these. Do not induce gagging without specific training.
Steps: the sources do not give per-acting detail [uncertain]. Applied within the generic frame of 4.4, the steps would be [synthesis]:
1. Explain the acting and agree a stop signal.
2. Put the client in the basic position.
3. For a fixed position, the client holds it while breathing, and lowers it at once if there is pain or dizziness.
4. For a rhythmic acting, the client repeats the movement at their own rhythm.
5. Rest, then elaborate verbally (4.9).
Example language (illustrative): "Lift your head just off the couch and hold it there, breathing. Let it down whenever you need to."
Watch for: neck or shoulder strain. Before neck extension or rotation, screen for cervical spine problems and vertigo [synthesis]. Striking the couch can escalate into the discharge of anger. Apply the screening in 4.3 (cardiovascular illness, recent injury, psychosis, severe dissociation, trauma not yet stabilised). The client should strike a cushioned surface, at an intensity they stay in control of [synthesis].

4.6 Breath with light pressure on the upper abdomen (Reich's technique; touch)

Purpose / when: Reich combined deep breathing with light pressure on the upper abdomen to bring out the inhibition of breathing [source: Rocha et al. 2020, citing Reich 1978]. Whether and how Navarro's lineage uses it was not confirmed [uncertain].
Steps:
1. Consent first [synthesis, standard good practice]: explain where your hand will go (the upper abdomen, just below the ribs), why, and for how long. Ask explicitly. Offer a no-touch alternative, such as the client placing their own hand there. Agree a stop signal. Check in during the exercise and afterwards.
2. The client is in the basic position (4.3) and breathes deeply.
3. With permission, rest a flat hand lightly on the upper abdomen and add gentle pressure on the out-breath. Use "light" pressure only [source: Rocha et al. 2020]; the amount and duration are not given in the sources [uncertain].
4. Remove your hand, rest, and talk it through (4.9).
Example language (illustrative): "I'd like to put a hand lightly here, below your ribs, while you breathe out. Is that all right? You can also put your own hand there instead. Say 'stop' at any time."
Watch for: breath held against the hand, nausea, panic, or a trauma reminder linked to touch. Stop and return to the no-touch option. Contraindications [synthesis]: pregnancy, abdominal surgery or injury, hernia, and a history of abuse in which this touch has not been explicitly agreed.

4.7 Massage in vegetotherapy (touch)

Purpose / when: Rocha et al. note that vegetotherapy, as Navarro describes it, uses massage and works "from head to feet" [source: Rocha et al. 2020, citing Navarro 1996]. "Reichian massage" is listed as a topic in Navarro's methods manual [source: Amenábar, presentation of Serrano 2020]. Oliveira lists "Reichian massage" and local muscle stimulation to "dissolve nodules", in the school's language [source: Oliveira 2023]. Reich himself used occasional pressure or focused massage on muscular rigidities, and acupressure on tense areas such as the masseters and the cervicothoracic zone, but did not use massage systematically [source: Vílchez & Serrano 2016; Serrano 2011, ch. 2].
ES.TE.R position: Serrano's school avoids direct contact with the patient's body ("evitamos el contacto directo con el cuerpo del paciente") and warns that touch can be iatrogenic [source: Serrano 2011, ch. 2]. Serrano does describe palpating tension points, such as the masseter nodule, as a diagnostic check, and palpating the same points again after several sessions to see whether the tension has eased [source: Serrano 2011, ch. 2].
Steps: no massage procedure (where, how deep, how long) is given in the sources [uncertain]. Default to the ES.TE.R no-touch approach. If you are trained in a lineage that uses massage, follow the consent sequence in 4.6, keep the head-to-feet direction, and never touch the breasts, genitals or buttocks [synthesis].
Watch for: deep-tissue pressure can cause pain, bruising and trauma reactions. Screen for recent injury or surgery, anticoagulant use, skin or vascular conditions, pregnancy and severe dissociation [synthesis].

4.8 Minimal contact during emerging emotion (touch)

Purpose / when: "only occasionally", to accompany or ease an emotion that is already emerging during an acting. It is never used to provoke one [source: Redón].
Steps:
1. Agree in advance, outside the emotional moment, whether contact is welcome, where (for example, a hand on the shoulder or forearm), and what the stop signal is [synthesis].
2. In the moment, ask briefly before touching. Offer presence and voice as the alternative [synthesis].
3. Keep the contact still, light and brief. Withdraw as the wave passes.
4. Discuss it afterwards, including how the touch felt [synthesis].
Example language (illustrative): "Would my hand on your shoulder help right now, or would you rather I just stay here?"
Watch for: freezing, compliance (saying yes but stiffening), or an erotic or transference charge. Name it and process it verbally rather than continuing.

4.9 Verbal elaboration after an acting

Purpose / when: after every acting. This is the second moment of the session, which turns the reaction into insight [source: Redón; Carmo & Ribeiro 2025; Rocha et al. 2020].
Steps:
1. The client rests, then sits up if needed.
2. Ask about sensations first, then emotions, then images, memories and thoughts.
3. Help the client link what emerged to their character pattern and history. Interpret "when appropriate", not on every occasion [source: Rocha et al. 2020].
4. Note the transference meaning (for example, how the client experienced you during the acting).
5. Before the client leaves, check that they are oriented and settled [synthesis].
Example language (illustrative): "What did you notice in your body? ... And when that tightness came, was there a feeling with it? ... Does it remind you of anything?"
Watch for: intellectualising without feeling (go back to sensation), or flooding with no capacity to reflect (ground the client and postpone interpretation).

4.10 Combining actings (Ferri's development)

Purpose / when: Ferri combines actings from the same or different developmental levels to target a particular emotional expression. The article presents this as current research rather than standard Navarro method [source: Carmo & Ribeiro 2025] [uncertain].
Steps: not described in the source. Use only after training in Ferri's model.
Watch for: combining raises the intensity. Apply the same screening as 4.3.

4.11 Level-by-level acting sequence (Navarro's seven levels)

Purpose / when: the backbone of full vegetotherapy. Navarro added actings for each of Reich's seven levels and ordered them top-down, following development [source: Carmo & Ribeiro 2025; Redón], in a set of exercises "com sequência e tempo definidos" (with a defined sequence and timing) [source: Volpi 2022]. Navarro's complete set is in his Metodologia, which is not drawn on here [uncertain]. Below are the targets, the sourced observations, and the actings that school and journal sources name for each level. Use 4.4 as the running frame.
Levels, with what the sources tie to each:
1. Eyes, ears and nose (telereceptors): the first contact with the world. Ocular blocks are prominent in psychotic and borderline structures [source: Redón; Ferri & Barbato 2022]. Named actings: convergence on a light that approaches and recedes, the lateral arc, "naso cielo", and a fixed gaze on a still light (see 4.5) [source: Lelii 2024; Psicologhe di famiglia; Volpi 2026].
2. Mouth: the oral relation, from feeding onwards. Strong oral blocks are seen in borderline structures [source: Redón; Ferri & Barbato 2022]. Named actings: sucking and biting, plus the SIAR "distancing" sucking variant (see 4.5a) [source: Psicologhe di famiglia; Lelii 2024].
3. Neck: cervical tension is typical of neurotic structures [source: Redón]. Named actings: the neck held off the couch, and neck rotation (see 4.5b) [source: Volpi 2026]. One unsigned site also lists the gag reflex [uncertain].
4. Thorax, including the arms: emotion that "resonates in the chest" [source: Carmo & Ribeiro 2025; Ferri & Barbato 2022]. Named actings: the arms raised and held, and the arms striking the couch (see 4.5b) [source: Volpi 2026]. One unsigned site adds reaching and hugging [uncertain].
5. Diaphragm: diaphragmatic blocks appear in psychotic and neurotic structures [source: Redón]. In Lelii's SIAR case, body work began with breathing to free the diaphragm, before the ocular actings [source: Lelii 2024]. No named diaphragmatic acting is given in the sources [uncertain]. Use breath awareness only (4.3).
6. Abdomen: the first level in Ferri's re-ordering [source: Carmo & Ribeiro 2025]. No named abdominal acting is given in the sources [uncertain].
7. Pelvis, including the legs: in the school's model, the level of standing and of "genital" sexuality. Pelvic tension is typical of neurotic structures [source: Redón]. One unsigned site names pelvic movement and grounding, and warns that work at this level done too early can be iatrogenic [source: WilhelmReich.com.br]. No named pelvic acting is given in the sources [uncertain].
Developmental frame used by the school: intrauterine, oro-labial, muscular/anal, phallic and two "genito-ocular" phases [source: Carmo & Ribeiro 2025]. How these map onto the levels is not detailed in the sources [uncertain].
Example language (illustrative): "For the next weeks we'll stay with your eyes. The same simple movement each time, until it starts to feel different."
Watch for: do not move downward while a higher level is still producing distress or numbness. Never work "upwards" with a client who may have a psychotic core [source: Rocha et al. 2020]. Pelvic-level work: never sexual or genital touch. Pelvic work is done by the client's own movement and breath, and requires explicit discussion of boundaries [synthesis].

4.12 Brief Characteranalytic Psychotherapy (PBC; ES.TE.R)

Purpose / when: a focal, time-limited application of vegetotherapy. Best results are reported for phobic and anxiety states, crises, depressive states, sexual dysfunctions, existential crises, confusional states, distress syndromes, couple conflict and some personality disorders. Prognosis is "reservado" (guarded) where the symptoms are the visible part of a structural or degenerative process [source: Infocop 2008].
Steps:
1. Carry out the D.I.D.E. (4.1). Exclude psychotic structures from the focal model.
2. Choose the focus: a character trait weakened by current stressors that unbalance the person's defensive self-regulation.
3. Hold about 20 weekly sessions over roughly six months, combining respiratory and neuromuscular techniques with psychoanalytic work: the relationship and free association.
4. Phase 3 (months 4–6): combine individual and group sessions.
5. Treat sexual problems individually or in couple sessions, depending on whether they are tied to the couple's conflict [source: Infocop 2008].
- What is done in phases 1 and 2, and how the therapy ends, was not found [uncertain].
Example language (illustrative): "We'll work for about six months on one thing: the way you've been holding yourself together since the move, and what it costs your body."
Watch for: Signs it is working are reduced symptoms and more flexibility in the focal trait. Unclear structural problems that surface during PBC suggest a switch to full vegetotherapy or another treatment [synthesis].

4.13 Group sessions (PBC phase 3)

Purpose / when: group sessions are added to individual sessions in months 4–6 of PBC [source: Infocop 2008]. Their content is not described [uncertain].
Steps: follow your ES.TE.R training. At a minimum, screen group members, agree confidentiality and no-touch-without-consent rules, and do not run high-intensity actings in a group without co-therapists [synthesis].

4.14 Navarro's adjuncts for "biopathies": report only, do not use

Serrano reports that Navarro treated what he called "biopathies" (cancer, diabetes, hypertension, arthritis) by combining psychotherapy with diet, trace elements, homeopathy and the orgone accumulator [source: Serrano 2004]. This guide does not present any part of this as treatment for physical disease. Refer clients with medical illness to medical care, and keep body psychotherapy to its psychological scope [synthesis].

4.15 Holding the frame with borderline clients

Purpose / when: Ferri and Barbato's case shows irregular attendance, disappearances, idealisation alternating with devaluation, and fear that therapy would make the client "normal" [source: Ferri & Barbato 2022].
Steps: set firm limits. In their case missed sessions were charged without notice, and the client had to clarify the therapeutic situation when she saw another therapist. Keep "inclusion at a fair distance" and use "mirroring contact". Keep the body work gentle, with "reasonable and intelligent challenge", because energetic lowering can lead to decompensation [source: Ferri & Barbato 2022]. Agree the fee and absence policy in writing at the start [synthesis].
Example language (illustrative): "You're free to come and go in what you feel here. The sessions stay where they are, and I'll be here."
Watch for: depression "masquerading as psychosis" during decompensation [source: Ferri & Barbato 2022]. Reassess risk and reduce the intensity of body work.

5. Handling problems

The sources say little about problem-handling. Items without a [source] tag are [synthesis].

Overwhelm or flooding during an acting (panic, uncontrollable crying, shaking, loss of orientation).
- Stop the acting. Have the client open their eyes, sit up and put their feet on the floor. Return the breath to normal. Name the room and the time. [synthesis]
- Next session, shorten the acting and lower its intensity. Keep the work "gentle" and "respectful of limits" [source: Ferri & Barbato 2022].
- Re-check the D.I.D.E. A flood that is hard to contain may point to a borderline or psychotic core. Navarro warned of an "uncontrolled crisis" when energy is pushed upward in such structures [source: Rocha et al. 2020].
Signs of psychotic decompensation or severe dissociation (derealisation that persists after the session, perceptual disturbance, disorganisation).
- Stop segmental and breath work altogether. Assess risk, involve psychiatric care, and switch to supportive and stabilising work. [synthesis]
- The school holds that psychotic structures need a specific treatment and are outside the focal PBC model [source: Infocop 2008; Rocha et al. 2020].
Suicidality emerging (for example, during depressive "lowering"). Run a standard structured suicide risk assessment and safety planning, including lethal-means counselling (safe storage and removal). Suspend intensive body work until the client is stable. [synthesis]
Stuck: the acting stays unpleasant or neutral for months.
- Repetition over months is expected, at least six months in Ferri's account [source: Carmo & Ribeiro 2025].
- If nothing moves, check that the acting is done with intention rather than mechanically. Analyse the manner of performing it as character resistance (4.2) [source: Redón]. Consider whether a higher level is still blocked.
- Discuss in supervision whether the level or the order should change (Navarro's order versus Ferri's). [synthesis]
Resistance: compliance, "good patient" performing, or refusing actings.
- Treat it as character material to analyse, not to override [source: Redón].
- Offer a lower-intensity version (breath awareness only, 4.3) or a verbal-only session. Never pressure the client into an acting. [synthesis]
Intellectualising after actings. Bring the client back to sensation before meaning ("feel first, think after") [source: Carmo & Ribeiro 2025].
Non-adherence: irregular attendance, disappearances [source: Ferri & Barbato 2022].
- Hold a firm and predictable frame, including the fee for missed sessions if agreed.
- Clarify parallel treatments.
- Interpret the coming and going as closeness-distance fear (engulfment or abandonment).
Ruptures: idealisation alternating with devaluation, or touch experienced as intrusive.
- Use "inclusion at a fair distance" and "mirroring contact" [source: Ferri & Barbato 2022].
- After any rupture involving touch: acknowledge it, return to no-touch work, re-negotiate consent explicitly, and document it. [synthesis]
- Countertransference: if you notice yourself pushing for discharge or results, take it to supervision. Navarro's lineage treats the therapist's unresolved neurosis as interfering with the effects of actings [source: Redón].
Trauma, especially sexual trauma, disclosed during body work.
- Ferri's client disclosed sexual violence only later in therapy [source: Ferri & Barbato 2022].
- Prioritise stabilisation. Avoid pelvic- and abdominal-level actings and any touch until the client chooses them. Consider trauma-focused treatment and the mandatory reporting rules that apply to you. [synthesis]
Physical symptoms during breath work (tingling, cramping or dizziness from over-breathing, chest pain). Stop and normalise the breath. Chest pain or fainting needs medical assessment. Screen in advance for cardiovascular and respiratory illness, epilepsy and pregnancy. [synthesis]
Client wants the method to treat a physical illness (Navarro's "biopathies"). State plainly that this psychotherapy does not treat physical disease. Coordinate with the client's physician. [synthesis]
Training gap. Only some of the level-specific actings could be sourced (4.5–4.5b). The rest of Navarro's set, for the diaphragm, abdomen and pelvis, is not described here, and you should not invent substitutes. For its vegetotherapy specialism, ES.TE.R requires prior specialisation in PBC, its trainings in human ecology and in human sexualities, a personal vegetotherapy, small-group clinical seminars, and individual supervision until at least three of the trainee's own cases are completed [source: ES.TE.R 2023]. Until you are trained, limit yourself to 4.1–4.4, the simplest ocular actings in 4.5, 4.8 and 4.9, under supervision [synthesis].
Delayed reactions after body work. Serrano warns of three risks: anxiety episodes during somatic release, adverse reactions once psychic defences are uncovered, and greater vulnerability to social aggression for a while afterwards [source: Serrano 2011, ch. 2]. Warn clients in advance, give them a way to contact you between sessions, and slow the pace of level work if these appear [synthesis].

Sources

Sources:

Further reading (not drawn on) [uncertain]:

Navarro F. Metodologia della vegetoterapia caratteroanalitica (Spanish edition: Metodología de la vegetoterapia caracteroanalítica, 1990).
Navarro F. La somatopsicodinamica (Spanish edition: Somatopsicodinámica, 1988).
Navarro F. Caracterología post-reichiana (1991).
Navarro F. (1996), as cited by Carmo & Ribeiro 2025 and Rocha et al. 2020.
Serrano X. (1990). On initial-differential structural diagnosis (D.I.D.E.).
Reich W. (1933). Character Analysis.
Ferri G., Cimini G. (2012/2022). Carattere e Psicopatologia. Alpes Italia.
Serrano Hortelano X. (2011). Profundizando en el diván reichiano. Biblioteca Nueva (ch. 2 only, via Esternet).
Serrano Hortelano X. (2020). La psicoterapia caracteroanalítica (publisher's presentation only).

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