Reichian analysis, Italian school

1. Introduction

Version followed: "contemporary Reichian analysis" as taught by the Italian School of Reichian Analysis (S.I.A.R., Rome) under Genovino Ferri, which Ferri calls Character-Analytical Vegetotherapy of the Relationship (CAVR). The main sources are Ferri's 2016 IBPJ paper Supervision in Reichian Analysis, articles by Ferri and S.I.A.R. analysts on the S.I.A.R. site and in its journal Psicoterapia Analitica Reichiana, and Ferri and Cimini's Carattere e Psicopatologia (Alpes, 2012; 2nd ed. 2022; front matter only), plus a review of Ferri's book on the actings and a 2025 secondary account. Ferri is a psychiatrist trained in Reichian analysis by Federico Navarro, is president of S.I.A.R. and director of its school, and formerly directed the psychiatric unit at Atri hospital and a public psychotherapy service in Teramo [source: EABP 2016 speaker page; Ferri 2016; Mannella 2019]. S.I.A.R. was set up in Rome in 1992, growing out of S.E.Or (founded 1979), and runs a four-year psychotherapy school recognised by the Italian Ministry of University and Research (MIUR) since 2004 [source: Mannella 2019, S.I.A.R. site]. The S.I.A.R. sources do not name its founders [uncertain]. Supported by sources: two individual actings (the fixed point and sucking), the therapist's position, the use of focused pressure or massage, the 15-minute duration of S.I.A.R.'s published actings, the developmental order of the levels and the title of Ferri's actings book (S.I.A.R. sources). The other 18 or so actings in Ferri's book, session frequency and length, number of sessions, ending criteria, a contraindication list and a written touch policy remain [uncertain].

What it is. It is a psychoanalytically based body psychotherapy that develops Reich's character analysis and vegetotherapy. Navarro gathered Reich's body techniques, called them actings, and set rules for how long, at what rhythm and in what direction each is done. Ferri's school keeps Navarro's actings but adds three things. First, it reorders Reich's seven body levels from bottom to top so that they follow development from conception onward. Second, it ties each level to a developmental ("evolutive") stage and to a character trait. Third, it treats the therapist–patient relationship itself as something to be analysed and worked on through the body ("intersubjective-intercorporeal") [source: Ferri 2016; Anastasova review]. Ferri calls the result a "three-dimensional" vegetotherapy: stage × trait × relational body level [source: Anastasova review].

How change happens, in the school's own theory. Relationships with the "partial objects" of each developmental stage leave "incised marks" (Ferri's gloss on the Greek root of character). These marks are stored as character traits on the body level that first received that relationship, and they are repeated in the transference [source: Ferri 2016]. The therapist chooses an acting that fits the patient's stage and body level, and doses it in time, rhythm and direction. Ferri calls actings "fractal elevators of internal time" because they link "then and there" with "here and now". Together with a deliberately chosen countertransference, the acting produces "embodied activation": new trait patterns that grow "from within the bodily self, outwards". The school calls the hoped-for direction negentropy, meaning greater organisation, and its stated physiological aim is eutony, balanced tone across muscles, the autonomic system and the neuroendocrine system [source: Ferri 2016; Mattos do Carmo & Ribeiro 2025]. Terms such as energetic pulsation, negentropy and the neurotransmitter links (noradrenaline, dopamine, serotonin) are Ferri's and Navarro's theoretical model. They are not established physiology, and Ferri himself says the model oscillates between science and pseudo-science [source: Ferri 2016]. The method is not a treatment for physical disease.

2. Framework

No published phase manual with fixed session counts was found [uncertain]. The framework below puts together Ferri's 18-step case formulation, his treatment-project and 6-month review logic, and the acting dosing rules reported for the school [source: Ferri 2016; Mattos do Carmo & Ribeiro 2025]. The ordering into phases is my own arrangement [synthesis].

The developmental map (the school's model). These are the levels in Ferri's bottom-up order, with Reich's level number in brackets. Ferri gives the sequence of activation as 6-2-4-3-5-7-1 [source: Ferri 2016; Ferri, Analisi Reichiana e Vegetoterapia Caratteroanalitica dal 1933 al 2022; Mannella 2016; Mattos do Carmo & Ribeiro 2025]:

Umbilical area / abdomen (Reich's 6th): intrauterine stage, which Ferri divides into an "autogenous" and a "trophoumbilical" part; the first field is the mother.
Mouth (2nd): oral-labial stage; transition at weaning.
Chest and arms (4th): muscular stage.
Neck (3rd): first genito-ocular stage.
Diaphragm (5th): first genito-ocular stage.
Pelvis and legs (7th): second genito-ocular stage.
Eyes, ears and nose (1st): second genito-ocular stage; puberty. The fields widen from the mother (intrauterine and oral stages) to the family (father, siblings) and then to sociality; Ferri adds a fourth "cosmic" meta-field [source: Ferri 2016].

The stage assigned to each level comes from Ferri 2016 for the first three levels (intrauterine, oral, muscular), which a S.I.A.R. analyst confirms (abdomen first, then mouth, then chest as the muscular phase, then neck, diaphragm, pelvis and eyes) [source: Mannella 2016]. The pairing of neck and diaphragm with the first genito-ocular stage, and of pelvis and eyes with the second, is given on a Reichian analyst's practice page that follows the S.I.A.R. reordering [source: Raffo]; it was not found in a text by Ferri himself [uncertain]. An earlier version of this guide placed neck and diaphragm in the muscular stage; that was an inference and has been corrected. Ferri names these traits: intrauterine, oral, muscular, hysterical and genital (each with sub-types). He also mentions phallic-narcissistic and anal traits. The prevalent transitions he names are birth, weaning, the Oedipal phase and puberty [source: Ferri 2016]. A brain layer is added, drawing on MacLean's three brains and on the amygdala, anterior cingulate, locus coeruleus and prefrontal cortex [source: Ferri 2016]; Mannella links the abdominal level to reptilian and limbic dominance, the chest to limbic dominance, and the later levels to limbic and neocortical dominance [source: Mannella 2016]. These are the school's models, not measurements.

Phase A – Assessment and formulation (opening sessions; number not specified [uncertain]). Goal: a three-way diagnosis (analytical-characterological, clinical-psychopathological using DSM-5, ICD-10 and PDM, and relational), plus the prevalent traits, transitions, body levels and fixations, and the patient's explicit and implicit questions. Format: face-to-face history-taking and observation of the "language of traits". Move on when the formulation and a general project are in place [source: Ferri 2016 steps 1–12].

Phase B – Therapeutic project. Goal: a "general" project (the whole ontogenetic arc) and a "targeted" project (which stage and level to start from, which acting, and which countertransference stance). Selection depends on stage, level, the patient's story, trauma and current unease, and the frame of the setting [source: Ferri 2016 step 16].

Phase C – Vegetotherapy of the relationship (the bulk of therapy). In each session the patient does an acting, usually lying on a couch (lettino) or mat, knees bent and feet on the surface [source: Mannella 2016; Dolce 2017]. Ferri compares the acting to a drug dose. A secondary account reports 8–15 minutes [source: Mattos do Carmo & Ribeiro 2025]; the two S.I.A.R. actings published in detail each run for 15 minutes [source: Dolce 2017; Mannella 2016]; Italian Wikipedia gives 15–25 minutes for classic vegetotherapy actings and links this to the length of a REM-sleep phase [source: Wikipedia (it), secondary]. Verbal working-through of sensations, emotions and free associations follows every acting, then character analysis [source: S.I.A.R. 2022, Vegetoterapia carattero analitica]. The same acting may be repeated for at least six months, a period Ferri links to the time needed to repair a loss and to the oral-labial phase. Over the course of therapy, work moves through the levels in developmental order, respecting the patient's "internal time" [source: Mattos do Carmo & Ribeiro 2025, reporting Ferri]. In the classic method the therapist sits beside the patient rather than behind, and stays neutral; the therapist may also use silence, a change in how they look at the patient, or encouragement of the voice to bring out emotion [source: Ferri, Komi & Serrano-Hortelano 2017]. For the fixed-point acting the therapist sits behind the patient to hold the light [source: Dolce 2017]. Transference and countertransference are analysed throughout. Session frequency, session length and total number of sessions are not given in S.I.A.R. sources [uncertain].

Phase D – Six-monthly review ("validation of negentropy"). At baseline, patient, analyst and the relationship are each rated on a 0–100 self-rating, with 80–100 counted as well-being. The ratings are repeated at about six months, and the course is classed as entropic (worsening), negentropic (improving) or stasis. Ferri presents this as an "elementary" code, not a validated instrument [source: Ferri 2016 step 17].

Criteria for moving on.

From one acting or level to the next: a true "unlocking" is shown when an acting that first felt unpleasant or indifferent becomes pleasurable, and that change lasts over time [source: Mattos do Carmo & Ribeiro 2025, attributing this to Ferri].
From one stage of therapy to the next: the six-month negentropy review, and the "degree of progression of the analytic-therapeutic relationship" (step 15) [source: Ferri 2016].
No ending criteria were found. A reasonable ending point is sustained negentropic ratings, symptoms below threshold, and a relational style that has become sustainable in the here and now [synthesis].

3. Guiding principles

Character is relational and stratified. Read every symptom and stance as a trait laid down with a particular partial object at a particular stage. In practice, always ask "which stage, which level, which relationship" [source: Ferri 2016].
The symptom is a trait "beyond threshold" and has intelligent sense. Ask what the symptom achieves, what "economy" it supports and what it signals, rather than only suppressing it [source: Ferri 2016 step 10].
Bottom-up, developmental order. Choose levels in ontogenetic order (umbilical → mouth → chest → neck → diaphragm → pelvis → eyes), not Reich's original top-down order [source: Ferri 2016; Anastasova review].
Actings have a dose. Time, rhythm and direction are prescribed (Navarro's criteria of tempo, ritmo, direzione), and the acting is repeated for months. S.I.A.R.'s published examples last 15 minutes. Do not improvise lengths [source: Ferri, Komi & Serrano-Hortelano 2017; Dolce 2017; Mannella 2016; Mattos do Carmo & Ribeiro 2025; Ferri 2016].
Actings are neither good nor bad. They are not gymnastics. Their effect depends on the fit between acting, level and person, and they act anywhere from hypotonic to hypertonic blocks. Never use an acting as a routine exercise [source: Mattos do Carmo & Ribeiro 2025].
Appropriateness: one optimal solution. Ferri builds on Reich's line: "A certain analytical situation has only a single possible optimal solution." Aim for the single best-fitting intervention for this patient now [source: Ferri 2016].
Sensing before understanding; the patient's internal time sets the pace. During the acting the patient attends to sensation rather than talking. Interpretation comes afterwards [source: Mattos do Carmo & Ribeiro 2025].
Emotion first, then verbal elaboration. Expression should be emotional but "ordered", then integrated in words. (This is stated for the sister Spanish Navarro lineage. Its application to S.I.A.R. is inferred [uncertain].) [source: Redón Blanch]
The relationship is a third participant. The setting and relationship form a "trialogue" with their own character. Diagnose the relationship's character, not only the patient's [source: Ferri 2016; Anastasova review].
Chosen countertransference. Place yourself deliberately, through "functional, empathic collocation", on one of your own traits and body levels that the patient can use. In practice, decide how you will be with this patient as well as what you will do [source: Ferri 2016; Anastasova review].
Read the "language of traits". Content matters less than voice, posture, gesture, breathing, skin colour and autonomic signs. Note these every session [source: Ferri 2016].
Fractal recurrence. Look for the same relational theme (for example inclusion versus exclusion) repeating across stages, levels and symptoms [source: Ferri 2016 step 8].
The client's own "life-force intelligence" reorganises the system. The therapist activates; the patient's organism does the reorganising [source: Anastasova review].
Qualities of the setting. Benevolence, intelligence, precision, responsibility, ethics, acceptance and humanity. The setting is a "small biosphere", and its time frame is central [source: Anastasova review; Ferri 2016].
Touch is limited and purposeful. In the S.I.A.R. account of the method the therapist may intervene with focused pressure or massage where needed, and Mannella names massage of a stiffened muscle as a Reichian somatic intervention [source: Ferri, Komi & Serrano-Hortelano 2017; Mannella 2019]. The S.I.A.R. texts give no written consent procedure or touch policy [uncertain]. The Spanish Navarro lineage puts it this way: touch is minimal and used only to make contact or to help an emotion already present, "Trabajamos con la persona y no sobre la persona" [source: Redón Blanch].
Interdisciplinary and medical realism. Diagnoses should agree across DSM, ICD and PDM, and medication or psychiatric care can sit inside the same therapeutic "architecture". Do not treat body work as a substitute for indicated psychiatric treatment [source: Ferri 2016].
Respect fear. Fear is a sign of the organism's intelligence. When it crosses the threshold it must be recognised and its origins understood, "lay your eyes upon it" [source: Ferri 2012 abstract].

4. Intervention inventory

Coverage note. Ferri's book on the actings, Il tempo nel corpo. Attivazioni corporee in psicoterapia (Alpes, CorporalMente series; English edition Body Time – Bodily Activations in Psychotherapy), presents 20 actings as a dialogue between Ferri and a group of colleagues, with volunteers trying each one [source: Anastasova 2023–24; unilibro listing]. Navarro's 1988 methodology gives the classic per-level actings. Neither book is drawn on here (a copy of Navarro's text found online is not an authorised edition and was not used). Two S.I.A.R. actings are published in enough detail to describe here: the fixed point (level 1, 4.11a) and sucking (level 2, 4.11b). Deep breathing (4.9, 4.11c) and focused pressure or massage (4.11d) are also documented. For the remaining actings this inventory gives (a) the formulation and relational interventions Ferri describes in full, (b) the acting procedure common to all actings (position, dosing, closure) and (c) the purpose of each relational body level. It does not invent actings [uncertain: the other actings' names and instructions]. Before using actings, a clinician needs S.I.A.R. or equivalent training and Ferri's or Navarro's texts. Touch-based work in particular requires specific training, supervision, and a check of what the clinician's licence and jurisdiction allow.

4.1 Four-perspective case history (steps 1–4)

Purpose / when: at intake, to collect the patient's ontogenetic "incised marks" and the context of the illness [source: Ferri 2016].
Steps:
1. Analytical-psychodynamic history. Cover the circumstances of conception and birth and the "implicit project" of the family scene. Cover the embryo–mother dialogue from intrauterine life to weaning, birth, weaning and birth order. Cover the father and the family, the Oedipal scene, who led the parental couple, the parents' relationship, the family atmosphere, and puberty.
2. Remote pathology. Ask which past illnesses occurred, at which stage, in what family or systemic scene, and in which body level or organ system. Note the resulting resilience (capacity to adapt under stress) and vulnerability.
3. Current pathology. Is it beyond threshold? Record the five main symptoms, how each shows in the body, timing, external triggers, structural vulnerability, and which trait the vulnerability belongs to.
4. Socio-economic history. Gender and sexuality, weight changes (record only, no targets), regional culture, religion, education, finances, occupation, moves and social status.
Example language (illustrative): "What do you know about the time before and around your birth: how things were for your mother, what the family was going through?" / "How was weaning, and how was it when a brother or sister arrived?"
Watch for: the manner of telling, not only the content (see 4.2). Gaps in the patient's knowledge of their early history are data too. Prenatal and perinatal questions can stir guilt or grief: ask, do not press [synthesis].

4.2 Reading the "language of traits"

Purpose / when: in every session, to pick up the implicit information that the ego does not attend to [source: Ferri 2016].
Steps:
1. While listening, track word choice, voice, facial expression, posture, gesture, movement, skin colour, breathing and autonomic signs.
2. Note which body level the patient mostly "uses" with you: abdomen, mouth, chest and arms, diaphragm, neck, eyes, or pelvis and legs.
3. Note which "brain" the patient seems to face you with (Ferri distinguishes reptilian, limbic and neocortical) and which alarm pattern shows. Ferri links external danger to the amygdala and locus coeruleus, and abandonment or exclusion fears to the anterior cingulate.
4. Write these down as hypotheses for formulation; do not offer them as interpretations straight away [synthesis].
Ferri's own diagnostic questions, used as observation prompts: Is depressive withdrawal also in a chest that is "crushed while exhaling"? Is a paranoid alarm also in the shoulders? Is obsessive fixity also in a rigid gaze? Is borderline anger also in a chin thrust out in challenge? Does an anxious "tired chest" change your own breathing? How do a panicking patient's pallor and terrified face affect you? Where is a psychotic patient's "emptiness", and is it also deep in the viscera? [source: Ferri 2016, paraphrased]
Watch for: observations that confirm or disconfirm across sessions. Treat brain-area labels as the school's model, not as measurement [synthesis].

4.3 Three-way diagnosis, differential diagnosis, explicit and implicit questions (steps 5–12)

Purpose / when: after the history, before setting the project [source: Ferri 2016].
Steps:
1. Identify the prevalent fixations across the stages (intrauterine, oral-labial, muscular, first and second genito-ocular).
2. Identify the prevalent traits and transitions and how they interact. Ferri's example: a prevalent oral trait arising from a difficult weaning (the move from the mother field to the family field) can inhibit later muscular traits.
3. Identify the prevalent body levels and evolutive brains.
4. Formulate the fractal aetiopathogenesis: the self-similar theme (for example inclusion versus exclusion, which Ferri roots in the intrauterine stage) that recurs in relational style and in symptoms.
5. Make the clinical-psychopathological diagnosis with DSM-5, ICD and PDM and check that they agree. Then make a differential diagnosis that weighs risk and vulnerability and justifies the choice.
6. Separate the explicit question (what the patient asks for) from the implicit questions (unconscious ones held in traits and implicit memory).
Example language (illustrative): "You came asking for help with the panic attacks. I also notice that in almost every story you tell, the question is whether you are let in or left out. Does that fit?"
Watch for: any beyond-threshold condition that needs psychiatric or medical care first, such as psychosis, severe depression or suicidality. Ferri's framework explicitly includes psychiatric diagnosis and medication within the treatment architecture [source: Ferri 2016]. Do standard suicide risk assessment wherever risk is present [synthesis].

4.4 Scene analysis and relational positioning (step 9; ubi sum / ubi est / ubi sumus)

Purpose / when: to compare the historical "there and then" with the "here and now", and to map the patient's position in key relationships [source: Ferri 2016].
Steps:
1. For each key relationship, past and present, place the patient as up, down, meta, symmetrical or in alliance.
2. Ask three questions: ubi sum (where am I, the therapist, with this patient), ubi est (where is the patient) and ubi sumus (where are we, as a coupling of two sets of traits).
3. Judge how compatible your traits and implicit questions are with the patient's. Compatibility tends toward alliance and liking; incompatibility tends toward antipathy and symmetrical escalation.
Example language (illustrative): "With your father you always had to look up; with your partner you end up fighting as equals. Where do you find yourself with me?"
Watch for: symmetrical escalation in the room, which signals that trait incompatibility needs repositioning (see 4.6) [synthesis from Ferri 2016].

4.5 Transference analysis by "state, trait and body level" (step 13)

Purpose / when: throughout therapy. Transference is the repetition of infantile object-relation prototypes in the analytic relationship [source: Ferri 2016].
Steps: at each review, describe (a) the patient's current state, (b) which trait is being repeated toward you, and (c) through which body level. An example would be a mouth-level oral transference of craving, or an eye-level vigilance. Interpret when the patient can use it, linking it to the history from 4.1 [synthesis on timing].
Example language (illustrative): "When I was a few minutes late, your jaw set and you went quiet, the way you described waiting for your mother."
Watch for: recognition that comes with a felt bodily shift, rather than intellectual agreement only [synthesis].

4.6 Chosen countertransference and bodily identification (step 14)

Purpose / when: to use your own body as an instrument and to pick, deliberately, the stance the patient needs [source: Ferri 2016; Anastasova review].
Steps:
1. Notice which of your own body levels respond to the patient: tight throat, held breath, heavy belly, restless legs.
2. Name your countertransference by state, trait and body level.
3. Choose a "functional, empathic collocation": a trait and level of your own from which you can meet the patient's internal time. For example, offer steady, warm presence to an intrauterine or oral trait, and clear, non-symmetrical firmness to a challenging muscular trait (these examples are illustrative [synthesis]).
4. Check that the chosen stance stays flexible enough for "co-evolution".
Watch for: countertransference that becomes a rigid role, or that is acted out rather than used. Bring it to supervision (4.13).

4.7 General and targeted therapeutic project (steps 15–16)

Purpose / when: after formulation, and revised at reviews [source: Ferri 2016].
Steps:
1. Rate the current degree of progression of the relationship.
2. Write a general project covering stages, traits, body levels and brain areas over the whole course, and a targeted project covering the starting level, the acting chosen for that stage and level, and the countertransference to adopt.
3. Match the choice to the patient's story, trauma and current unease, and to what the setting can hold.
Example language (illustrative), when explaining the plan: "Alongside talking, I'd like us to work regularly with one simple bodily exercise, starting with the belly and breathing, because much of what you describe seems to come from very early on. We'll do it for a set time each session and talk afterwards."
Watch for: a project that skips stages because the presenting symptom is "higher up". The school's logic is developmental and bottom-up [source: Ferri 2016].

4.8 Screening before body work

Purpose / when: before the first acting, and again when health changes. S.I.A.R. teaching says only that the guided move into the acting must sit inside the individual therapeutic plan because in some situations it "potrebbe risultare controindicato" (could be contraindicated) [source: Ferri seminar 2001, written up by Gentile, S.I.A.R. site]. No list of contraindications was found [uncertain], so the specific screen below is [synthesis].
Steps:
1. Ask about pregnancy; cardiovascular, respiratory and seizure disorders; recent injury or surgery; and pain or mobility limits for lying supine and for the movements planned.
2. Assess dissociation, psychotic symptoms, active suicidality, and recent trauma that has not yet been stabilised. Ferri's school does work with beyond-threshold conditions, but within psychiatric diagnosis and care [source: Ferri 2016]. For these patients, start with stabilising, low-intensity work and shorter durations, and work alongside the treating psychiatrist [synthesis].
3. Ask about past experiences of being held down, touched without consent, or medical procedures on the couch. The supine position itself can be a trigger [synthesis].
4. Get medical clearance where in doubt. Explain that the method treats emotional and relational problems and does not treat physical illness.
Watch for: signs of hyperventilation during deep breathing (tingling, light-headedness, cramping of hands or mouth). Slow the breath and sit the patient up if they appear [synthesis].

4.9 Basic position and breathing

Purpose / when: the standard starting position for actings. It is meant to lower resistance and support awareness of sensation [source: Mattos do Carmo & Ribeiro 2025].
Steps:
1. The patient lies on their back on the couch or mat, knees bent and raised (Ferri, quoting Raknes on Reich, gives about 45°), soles of the feet firmly on the surface, arms along the sides [source: Ferri, dal 1933 al 2022; Dolce 2017]. The fixed-point acting is done in a dimly lit room; in the sucking acting the eyes stay open [source: Dolce 2017; Mannella 2016].
2. Invite natural, then deeper, breathing with attention on sensation, not on talking.
3. In the school's account, deep breathing in this position brings a gradual rise of chest, abdomen and pelvis, softening shoulders and a slight backward tilt of the head. Reich linked these movements to his "orgasm reflex" concept [source: Mattos do Carmo & Ribeiro 2025]. Treat that as Reich's theory and as a sign of letting go. Do not set it as a goal [synthesis].
Reich's founding observation, as S.I.A.R. teaches it: a patient stopped breathing just before a painful subject. Instead of telling him to go on, Reich pointed out that he was not breathing and told him to breathe, and crying followed [source: S.I.A.R. Pisa event notice].
Example language (illustrative): "Lie back, knees up, feet on the couch. Let the breath come and go. You don't need to talk; just notice what you feel." / "I notice you stopped breathing just then. Let the breath go on."
Watch for: breath-holding at emotionally loaded moments (Reich's original cue). Watch also for over-breathing (see 4.8).

4.10 The acting: common procedure for every acting

Purpose / when: the core body intervention. A dosed, intentional neuromuscular movement that repeats an early, "phylogenetic" movement of the target stage and level. It opens access from the periphery of a body level to its centre, linking the then-and-there with the here-and-now [source: Mattos do Carmo & Ribeiro 2025; Anastasova review; Ferri 2016].
Steps (the core is sourced; details marked [synthesis] are added):
1. Choose the acting from the targeted project (4.7) according to stage, level, history and the current state of the session [source: Ferri 2016; Anastasova review].
2. Explain what the patient will do, for how long, and that they may stop at any time. Agree a stop signal [synthesis].
3. Position the patient (4.9) and demonstrate the movement if needed [synthesis].
4. Run it for the set time, about 15 minutes in S.I.A.R.'s published actings (a secondary account gives 8–15 minutes), at the prescribed rhythm and direction [source: Dolce 2017; Mannella 2016; Mattos do Carmo & Ribeiro 2025]. The patient does it intentionally and with attention, not mechanically, without speaking, and keeps the focus on sensations, emotions and thoughts [source: Dolce 2017; Mattos do Carmo & Ribeiro 2025]. The therapist does not interrupt with verbal interventions during the acting [source: Mattos do Carmo & Ribeiro 2025]. The therapist does track breath, colour, tremor, emotion and their own bodily countertransference (4.6) [synthesis].
5. Let emotion come in an orderly way. Allow crying, anger or fear that arise, without pushing for catharsis [source: Redón Blanch on "ordered" abreaction (Spanish lineage)].
6. Close: the patient stops, rests with normal breathing, opens their eyes if they were closed, sits up slowly and re-orients to the room [synthesis].
7. Talk it through (4.12): sensations, images, memories, free associations, and how the experience relates to the patient's character [source: Mattos do Carmo & Ribeiro 2025; Ferri 2016].
8. Repeat the same acting across sessions, for months if needed (Ferri gives at least six months as a typical span), before moving on [source: Mattos do Carmo & Ribeiro 2025].
Example language (illustrative): "We'll do this for about ten minutes. Keep the movement slow and steady and stay with what you feel. Raise your hand if you want to stop." / Afterwards: "What did you notice? Where in your body? What came to mind?"
Watch for / signs it's working: the acting moving from unpleasant or indifferent to pleasurable, and staying that way over time (the school's marker of an "unlocking") [source: Mattos do Carmo & Ribeiro 2025]. Other signs: new associations or memories linked to the target stage; softer tone or freer breathing at that level; changes in relating to the therapist [synthesis]. Stop if the patient dissociates, panics or gets physically unwell (see section 5).

4.11 Level-by-level purpose of actings (Ferri's bottom-up order)

Only the level 1 and level 2 actings in 4.11a–b could be verified; the named actings for the other levels were not found [uncertain]. The entries below give each level's relational meaning in the school's model, so that the clinician can see what an acting at that level is for. They are not exercises in themselves [source: Ferri 2016; Anastasova 2023–24; Mattos do Carmo & Ribeiro 2025; Mannella 2016].

Umbilical area / abdomen (Reich level 6), intrauterine stage. First receiver of the relationship with the mother in the womb. Linked to themes of inclusion versus exclusion, welcome versus persecution, and "psychotic emptiness" felt deep in the viscera. Actings here aim to reach the earliest, implicit marks.
Mouth (level 2), oral-labial stage. Marks of feeding, sucking and weaning (the move from the mother field to the family field). Linked to oral traits, craving, depression after loss, and the borderline chin thrust out in challenge. Ferri's six-month repetition span is tied to this phase [source: Mattos do Carmo & Ribeiro 2025].
Chest and arms (level 4), muscular stage. Reaching and holding, and breathing. Linked to the depressive chest "crushed while exhaling" and the anxious "tired chest".
Neck (level 3), first genito-ocular stage [source for stage: Raffo]. Holding back and control. Ferri places persecutory alarm in the shoulders [source: Ferri 2016]. Linking that alarm to the neck level is my inference [uncertain].
Diaphragm (level 5), first genito-ocular stage [source for stage: Raffo]. The breath block between upper and lower body. Early vegetotherapy relied on a few breathing actings centred on deep exhalation [source: Ferri interview, Mannella]. The Spanish lineage links diaphragmatic blocks to psychotic structures and, with neck and pelvis, to neurotic ones [source: Redón Blanch].
Pelvis and legs (level 7), second genito-ocular stage [source for stage: Raffo]. Grounding, sexuality as identity, and the Oedipal and pubertal transitions. Never sexual or genital touch.
Eyes, ears and nose (level 1), second genito-ocular stage and puberty. Contact with the social field. Linked to the obsessive rigid gaze. In Reich's and Navarro's tradition the eyes are worked first; Ferri puts them last [source: Ferri 2016; Ferri, Komi & Serrano-Hortelano 2017]. S.I.A.R.'s published level 1 acting is the fixed point with a small light (4.11a) [source: Dolce 2017].

4.11a Fixed-point acting (acting del punto fisso), level 1: eyes

Purpose / when: a level 1 acting. In the school's model it activates the prefrontal area and strengthens the sense of self; it helps the person "take stock of themselves" and not "lose the eyes" (non perdere gli occhi). Dolce describes it as useful when the person feels confused, scattered or anxious, and for planning and projecting oneself forward [source: Dolce 2017, S.I.A.R.]. Brain-area claims are the school's model, not measurement.
Steps:
1. Explain the acting and agree a stop signal; check the screen in 4.8 [synthesis].
2. Dim the room. The patient lies on a mat or couch, knees bent, feet firmly placed, arms along the sides [source: Dolce 2017].
3. The therapist sits behind the patient's head and holds a small light still above the patient's eyes. The light is not shone into the eyes; it is placed at a distance where the patient can converge comfortably, usually 15–20 cm above the point between the eyebrows, sometimes farther [source: Dolce 2017].
4. The patient looks at the light for 15 minutes without speaking, attending to sensations, emotions and thoughts [source: Dolce 2017].
5. Variant: if the light is felt as persecutory, "un occhio giudicante" (a judging eye), do the acting without it, with the gaze on a fixed point on the ceiling [source: Dolce 2017].
6. Close: the patient puts into words what they felt and the two elaborate it together; then the patient makes faces (smorfie) for a couple of minutes, which Dolce describes as spreading energy across the face [source: Dolce 2017]. Sit up slowly and re-orient before leaving [synthesis].
Example language (illustrative): "I'll sit behind you and hold a small light above your eyes, not shining into them. Just look at it for about fifteen minutes without talking, and notice what you feel. Tell me if it's too close, or raise your hand to stop."
Watch for: the distance at which the patient can converge comfortably (an unusually large distance is itself information about tolerance), and whether the light feels reassuring or intrusive [source: Dolce 2017]. Watch also for eye strain, headache or dizziness; stop if they appear, and do not use with acute eye conditions or photosensitive epilepsy without medical advice [synthesis].

4.11b Sucking acting (suzione), level 2: mouth

Purpose / when: an oral-labial level acting. Mannella presents it as an example of the actings used to bring awareness and try out new ways of being, not to produce abreaction [source: Mannella 2016, S.I.A.R.].
Steps:
1. Explain the acting and agree a stop signal [synthesis].
2. The patient lies on the couch, knees bent, feet on the mattress, eyes open [source: Mannella 2016].
3. With the mouth half open and the lips pushed forward, the patient repeats a sucking movement for 15 minutes [source: Mannella 2016].
4. Afterwards the patient puts into words the sensations, moods and thoughts that came up, and these are linked to the oral stage and to the formulation (4.12) [source: Mannella 2016; link to formulation is synthesis].
Example language (illustrative): "Keep your eyes open, let your mouth be a little open with the lips forward, and make a slow sucking movement. Keep it going for about fifteen minutes and notice what comes."
Watch for: feelings of hunger, longing, shame or disgust, and memories of feeding or loss; the movement turning mechanical; jaw or facial pain (stop if so) [synthesis]. The school's sign of progress is the acting becoming pleasurable over time (4.10).

4.11c Deep-breathing acting

Purpose / when: Reich's late vegetotherapy rested on a few actings, mainly breathing ones centred on deep exhalation; Mannella calls deep breathing the most important acting of that period [source: Ferri interview, Mannella; Mannella 2019]. In S.I.A.R. practice it underlies the basic position (4.9).
Steps: as in 4.9: supine, knees raised, feet on the surface, breathing deeply with attention on sensation and full exhalation [source: Ferri, dal 1933 al 2022; Mannella 2019]. No duration was given in the sources; use the 15-minute S.I.A.R. dose as a ceiling, and less with anxious or dissociative patients [synthesis].
Watch for: hyperventilation (tingling, light-headedness, cramping of hands or mouth): slow the breath and sit the patient up. Screen first for respiratory and cardiovascular illness, pregnancy, epilepsy and panic disorder [synthesis].

4.11d Focused pressure or massage

Purpose / when: the therapist may intervene with focused pressure or massage where needed, for example massage of a stiffened muscle to bring out the tension it holds [source: Ferri, Komi & Serrano-Hortelano 2017; Mannella 2019]. No further S.I.A.R. instructions were found [uncertain].
Steps [synthesis]: follow the consent steps in 4.15 every time; touch only non-intimate muscles such as the jaw, neck, shoulders or upper back; use light to moderate pressure, never deep-tissue force; keep it brief and stop at the first sign of pain, freezing or dissociation; talk it through afterwards.
Watch for: do not use over recent injury, surgery, inflammation, clotting disorders or anticoagulant treatment, or with patients for whom touch is a trauma trigger [synthesis]. Touch requires specific training, supervision and a check of what your licence and jurisdiction allow.

4.12 Post-acting verbal elaboration and character analysis

Purpose / when: after every acting, so that the body experience is integrated into meaning and into the analysis of character [source: Ferri 2016; Mattos do Carmo & Ribeiro 2025].
Steps: (1) Ask for sensations, then emotions, then free associations, in that order [source: Ferri 2016 on CAV's sequence]. (2) Link what emerged to the stage and trait being worked on and to the formulation (4.3). (3) Note any shift in the transference and analyse it (4.5). (4) Work with dreams as they come; Ferri lists dream interpretation among the acts the relationship "contains" [source: Ferri 2016]. (5) Close with how the patient leaves the session.
Example language (illustrative): "You said your mouth felt hungry and then you thought of your grandmother's kitchen. How does that connect with what you said about never asking for anything?"
Watch for: intellectualising that skips the felt sense. If it happens, return to sensation first [synthesis].

4.13 Validation of negentropy (six-monthly self-ratings)

Purpose / when: at baseline and about every six months [source: Ferri 2016 step 17].
Steps: (1) The patient rates their own well-being from 0 to 100. (2) The analyst rates the patient's condition and their own. (3) Both rate the relationship. (4) Repeat at about six months and classify the course as negentropic, entropic or stasis; 80–100 is taken as well-being. (5) Revise the project accordingly.
Example language (illustrative): "On a scale from 0 to 100, where 100 is feeling really well, where would you put yourself today? And how would you rate how we work together?"
Watch for: this is an informal code, not a validated measure [source: Ferri 2016]. Add standard symptom measures if your service requires them [synthesis].

4.14 Group supervision protocol (18 steps) and enacting actings in supervision

Purpose / when: for the clinician's difficult cases. It is run in groups and is open to therapists of other schools [source: Ferri 2016].
Steps:
1. Part one: present the case through steps 1–12 (4.1–4.3). The supervisor and group identify incised marks, stages, traits, levels, transitions and brains, and make the three diagnoses.
2. Part two: clarify the patient's transference and the analyst's countertransference, and the group's countertransference, each by state, trait and body level ("group bodily identification"). Rate how far the relationship has progressed, then propose psycho-corporeal guidelines and a general and targeted project (steps 13–16).
3. Agree the six-month negentropy check (step 17).
4. Step 18: the presenting analyst performs, in the group, the actings selected for the case. The aim is for the analyst to embody the appropriate position and "how" for that relationship before taking it back to the patient.
Watch for: the presenting analyst's own reactions during the actings, which become data for the countertransference stance [source: Ferri 2016].

4.15 Touch and consent

Sources: S.I.A.R. texts say the therapist may use focused pressure or massage when needed (4.11d) and that the therapist sits beside the patient, or behind for the fixed-point acting [source: Ferri, Komi & Serrano-Hortelano 2017; Dolce 2017]. They give no consent procedure [uncertain]. The Spanish Navarro lineage keeps manual contact minimal, used only for contact or to help an emotion already present to come out [source: Redón Blanch]. The steps below are [synthesis].
Steps: (1) Explain what touch, where and why, before the session. (2) Ask; accept no without question and offer a no-touch alternative, such as a verbal cue, a self-touch or a change of position. (3) Agree a stop signal. (4) Touch only non-intimate areas (for example a hand on the upper back or sternum), with the patient's eyes open if they prefer. (5) Check in during and after, and record consent in the notes. Never use sexual or genital touch.
Example language (illustrative): "Would it help if I placed a hand lightly on your upper back while you breathe? You can say no, or stop me at any time, and we'll do it without touch."
Watch for: freezing or compliance that looks like consent. Patients with trauma histories may need a no-touch approach throughout. Touch requires specific training, supervision, and a check of what your licence and jurisdiction allow.

4.16 Complex (combined) actings

Purpose / when: a direction reported for the school, not a standard procedure. It means combining basic actings from the same phase or from different phases into a personalised "complex" acting [source: Mattos do Carmo & Ribeiro 2025]. No instructions were found [uncertain]. Use only after training, and only once each component acting has been worked through on its own [synthesis].

5. Handling problems

The sources say little about problem management. Items marked [synthesis] are my own guidance, built from the school's principles.

The acting stays unpleasant or indifferent ("stuck"). The school's view is that the dose and time matter: repeat the same acting for months before judging, because unlocking shows as a lasting shift to pleasure [source: Mattos do Carmo & Ribeiro 2025]. If there is no change by the six-month negentropy review, revisit the formulation. The block may sit at an earlier level, given the bottom-up logic, or the relationship may be in stasis [source: Ferri 2016 steps 15–17; application is synthesis].
Performing the acting mechanically, like gymnastics. Actings are meant to be intentional and attended, not exercises [source: Mattos do Carmo & Ribeiro 2025]. Slow it down, shorten it, and ask for one sensation every few minutes beforehand, or afterwards [synthesis].
Resistance as character. In the Reichian tradition, resistance is analysed as character rather than overridden [source: Ferri 2016 on character analysis; Reich 1933]. Name the trait at work and its history ("the part of you that learned not to need anything"), and analyse it in the transference before pushing the body work [synthesis].
Wanting only to talk, or refusing body work. Respect the refusal and work with the language of traits, transference and countertransference, all of which are full interventions in Ferri's model. Offer a minimal, seated version of the breathing focus later [synthesis].
Overwhelm, panic or abreaction beyond tolerance. Stop the acting. Sit the patient up, eyes open. Orient to the room, with feet on the floor and slow exhalations. Name what happened and normalise it. In the next session, return with a shorter duration or a lower-intensity level [synthesis]. Ferri's stance on fear is to respect it and help the patient look at its origins, not to push through it [source: Ferri 2012 abstract]. With panic, attend to your own breathing and bodily countertransference, which Ferri explicitly asks about [source: Ferri 2016].
Dissociation or psychotic "emptiness". Stop deep or intense work. Keep eyes open, keep contact, and use brief, grounding activity. Make sure psychiatric care is in place. Ferri asks where psychotic emptiness sits in the body but treats such conditions within psychiatric diagnosis and care [source: Ferri 2016]. Pacing is [synthesis].
Suicidal ideation emerging after an acting. Pause body work. Do a structured risk assessment and safety planning, including lethal-means counselling about safe storage and removal, and involve psychiatric services as indicated [synthesis].
Hyperventilation or physical symptoms. Slow the breath, sit up, and refer for medical review if symptoms persist. Do not interpret physical symptoms only as "blocks" [synthesis].
Non-attendance and non-adherence. Ferri treats the setting's time frame as central [source: Ferri 2016]. Read missed sessions in transference terms (for example an oral trait's fear of dependence, or a muscular trait's need for control). Interpret that, and keep the frame stable [synthesis].
Ruptures and symmetrical escalation. Read them as incompatibility between the analyst's and patient's traits and implicit questions [source: Ferri 2016]. Re-run ubi sum / est / sumus (4.4). Shift your chosen countertransference to a different trait or level of your own (4.6). Acknowledge your part openly, and take the case to supervision (4.14) [synthesis on repair steps].
Over-identification or rigid countertransference. Use the group's "bodily identification" in supervision to see what you are carrying [source: Ferri 2016].
Modality-specific risks [synthesis]: (1) The theory can feel deterministic ("your weaning made you this way"). Offer it as a hypothesis and keep the patient's own meaning central. (2) Patients may take energy, negentropy or neurotransmitter language literally. Explain that these are the school's models. (3) Lying supine with a therapist watching can re-evoke trauma; agree the position and offer to sit up. (4) Never imply body work treats physical disease, and never replace indicated medication or medical care.
Gaps in this guide [uncertain]: the individual actings for levels 3–7 (names, movements, rhythm and direction), session frequency and length, number of sessions, ending criteria, and S.I.A.R.'s own contraindication list and written touch policy are not given in the sources. Only the fixed-point and sucking actings are verified. Consult Ferri's Il tempo nel corpo, Navarro (1988), and S.I.A.R. training before practising actings.

Sources

Sources

Ferri, G. (2016). Supervision in Reichian Analysis. International Body Psychotherapy Journal 15(1). This is the primary source for the model, levels, formulation steps, countertransference, project, negentropy validation and actings in general.
IBPJ article page: Supervision in Reichian Analysis
Anastasova, I. T. (2023–24). Book review : Genovino Ferri , Body Time – Bodily Activations in Psychotherapy. International Body Psychotherapy Journal 22(2), 145–147
Mattos do Carmo, L. A., & Ribeiro, A. C. P. (2025). O corpo na psicanálise: as ativações corporais e a neuroquímica das emoções na vegetoterapia caracteroanalítica contemporânea. Cadernos de Psicologia 7(12). A secondary source, in Portuguese, reporting Ferri's dosing and position.
Ferri, G., & Cimini, G. Carattere e Psicopatologia (Alpes, 2012/2022): front matter and introduction
IBPJ abstracts, Vol. 11 No. 1, including Ferri, "Anxiety and Panic in Reichian Analysis"
EABP Congress 2016: keynote speakers (Ferri biography)
IBPJ Vol. 15 No. 1 issue page
S.I.A.R. public event notice, Pisa 2018 (Reich breathing anecdote)
Redón Blanch, M. La Vegetoterapia Caracteroanalítica: un modelo de terapia psicocorporal (Spanish Navarro lineage)
Navarro, F. La somatodinámica sistemática reichiana: publisher's description only
Oliveira, G. F. (2023). A Terapia Corporal em Reich. Revista Latino-Americana de Psicologia Corporal 10(15). A secondary source, used only for the general mention of eye work with light.

Additional sources

Further reading (not drawn on in full)

Ferri, G., & Cimini, G. (2012; 2nd ed. 2022). Carattere e Psicopatologia. La psicoanalisi nel corpo e il corpo in psicoanalisi. L'analisi reichiana contemporanea. Rome: Alpes. English edition: Psychopathology and Character. Earlier book: Ferri, G., & Cimini, G. (1992). Psicopatologia e carattere. Rome: Anicia.
Ferri, G. Il tempo nel corpo. Attivazioni corporee in psicoterapia. Rome: Alpes (CorporalMente). English edition: Body Time – Bodily Activations in Psychotherapy. The 20 actings book; year of the Italian edition not verified [uncertain].
Navarro, F. (1988). Methodology of character-analytic vegetotherapy (as cited by Ferri 2016).
Reich, W. (1933). Character Analysis.

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