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CAPA ROLF LINES SUMMER 1997 - VOL 25 - N3

Rolfing in a Psychiatric Facility

Pages: 15-19
Year: 1997
Dr. Ida Rolf Institute

Rolf Lines SUMMER 1997- Vol. 25 – Nº 3

Volume: 25

Bill Harvey You’re doing something that as far as I can [ell has only been theorized about with anecdotal data here and there, but You’re actually Rolfing people in a psychiatric setting. You are actually confronting mental problems, along with a psychologist, simultaneously.

Bill Short: That’s true, we talked about this whale thing, early on of “Gee, I’m not an expert,” and you said something I thought was wonderful: “Well, nobody really is an expert but you’re doing some work here so let’s talk about it.” That’s kind of what it feels like. I’ve been doing this at this psychiatric facility now for tour Years, and it came about really through conversations with the inpatient director about why do psychiatric facilities that work so intensely on the head-stuff, the psychological process, not have components of different kinds of bodywork and something that helps the client to focus and center on body issues as well as psychological issues. It look us six months of back and forth negotiations before we actually Rut it set up, and I began there actually by doing sonic massage work, because they didn’t know what this Rolling thing was, until I had Rolled some of the therapists there. Once that was completed, I started seeing patients, and this is an inpatient psychiatric facility that primarily sees people with addictions and secondary diagnosis of some psychological problem, so it could be a chemical or sexual addiction with either primary or secondary diagnosis of depression, or anything and everything that you can imagine would fit into a psychological facility.

BH: So these people are living these, and they’re adding yon 1n with their treatment plan?

BS: That’s correct – exactly. I don’t have direct access to the treatment committee. I could do that, but I’m only giving one day a week to this, and when I’m there I’m really booked up, so taking amore time away from my practice to attend committee structures is a little difficult.

BH: Are you doing five people a day?

BS: Five or six.

BH: You’re doing full sessions?

BS: Right, doing full sessions, and primarily ten series. There ore sonic patients that I work with longer than that, particularly patients that we’ve determined have been significantly traumatized. Very often, patients in this facility begin to access memories of child abuse, some of it very significant, of psychosexual abuse, and the process of unwinding that mentally also can translate to physical body issues. So I work the ten series primarily and from that there are variations based upon what’s happening with the individual person.

BH: What’s happening in these sessions? Are they just sort of standard sessions, or are people dealing with psychiatric issues, or psychological issues while these sessions are happening?

BS: Both. Often times I will complete a session and the person will go directly to their psychotherapist, who’s on the same floor, or they will have come directly from their psychotherapist, so they will be talking, much more often than I have in my regular practice, about how particular aspects of what’s going on in their physical structure as we’re working, are relating to something that they’re working in their psychological process. Because they’re in patients, and they’re on site, they have a lot more time to process that kind of information. In the course of their treatment, they’re also encouraged to fill out “Significant Event” forms, which are filled out daily about some significant event that may have happened in the course of that day. And very often the Rolling appears as information on that Significant Event form.

For example, many of the clients that I see are remarkably touch deprived years and year; of no touch, as children and through their adulthood, so very often the process of discovering that they have a physical body, and it responds in certain ways, is in sonic ways new information. I think the other aspect of that is that as they are looking at: “I have a physical body.” When I say it’s not necessarily traditional sessions, sometimes I follow the ten series, but I may start out with someone who is so traumatized. that we basically work by helping them to become aware of the tart that they’re sitting in a chair; what their clothes feel like on their body, that kind of thing and working very slowly into the process. I’ve worked with people who have gone through torture, ritual sexual abuse, and other sorts of things like that, so I don ‘I approach it as I would approach a ten series, a traditional first client coming in take off your clothes, let’s do photographs that kind of thing. I do take photographs, however, so I have some kind of follow-up, which I think is really, realty important.

One of the things I found in working with a psychologically focused program: any kind of “objective” data like photographs, like information and feedback from the client, become very important, because the bias is that the change comes from the psychological. It really can come from either the work in the physical or the work in the psychological, and often comes from both. But in a way, to surf of establish my place, beyond Rolling the therapists and working with what is Rolfing, I had to develop and be really specific abort taking photographs, and charting each session as part of the medical record. A copy goes to the therapist, a copy goes to the central file, and I keep a copy. Very often I’ll talk to the therapist by phone during the week about what’s happening and they’ll give me feedback about what particular aspects that client is working on in their own treatment and recovery, if they’re in a recovery program.

Getting clients to talk about what’s happening, and encouraging clients to assume more responsibility (or their own care and well being is a part of what Rolling does, by it’s very nature, because we send people out, and we talk about how they may experience this newness in the week between the work on the table. I at least say to clients “In any opinion, what’s more important is what happens off the table, not on the table.” And as they’re walking and moving and experiencing the differences, if they experience any, and even if they don’t experience any, that’s something to work with as well. If someone is so shut down that I see change, and they’re not seeing change, then we have something else to work with.

I was so caught by a phrase, I think Torn Wing mentioned, and he talked about Dr. Rolf talking about “a differentiation equals maturation,” and one of the things that I was thinking about in terms of the client population that I work with in the center, is that Rolfing, because it’s a systemic process, a physical body unwinding, clients can participate, sometimes for the first time, in how their adult bodies feel. They can experience an increased somatic awareness. I think that that sense of maturation of the whole being, the whole person, at least the possibility of that being achieved is there. So that rather than a series (it pieces made tip of unresolved or frozen responses, Rolfing can offer the possibility to experience the integrated whole person, and that’s really profound for people who are feeling so fragmented, and who are coming into a process feeling so raw and vulnerable. Within the experience an image of wholeness becomes the container, or the container can hold a different sense of the experience of wholeness. ‘That’s really what’s been so fascinating to me in working with this program, is that a I see clients change and understand how early traumas may have affected their psychological development, they’re also, able to make that correlation to how it’s affected their physical development, and how those are changeable. It’s so remarkably empowering to have someone a t that level of teachable moment to be able to get the information.

“what’s been so fascinating to me in working with this program, is that as I see clients change and understand how early traumas may have affected their psychological development, they’re also able to make that correlation to how it’s affected their physical development, and how those are changeable.”

BH: Do you have any miracle stories?

BS: I think that there are no miracles. it’s just every day doing the work. Every day that I get there it’s just getting into the room, seeing what happens, and trying to stay as present as I can to what’s going on, and using the skills that I have to do something. Part of what really, truly drew me to Rolfing, as much as any single thing when I was looking at it, was the fact that in everything I read about Dr. Rolf and in all of the work that I could get my hands on about what she had written, site talked about the work as the important part, not the therapist. and that gravity was the therapist. I find this work incredibly humbling and I really like that. It separates me from having to create some kind of an ego need to be satisfied, So I don’t reaIly look for miracles in a Rotting session. I look Inc was I able to slay present to what was going on in the room did I miss stuff, in the wrap tip did I get stuff is that new information, is it something I can work with next tune, did I get through it With a relative ease and comfort in my own body as well as trying; to get some sense of comfort in the client’s body that kind of stuff.

BH: I guess I need to define miracle. I could say that in the beginning of lily practice there were a lot of miracles, and now there are hardly any, because the thing that’s different is I actually understand what I’m doing a little better, so if I don’t understand what I’m doing, to get a big change suddenly shows up as a miracle. But when vats do understand What you’re doing, it’s not a miracle, you’ve just done X,Y, Z and this has resolved itself. From the point of view of the psychotherapist or the client. I’m sure you’re creating; some miracles out there.

BS: Well, I think that’s true in that context. I think that the idea that a person can be in an intensive psychological process and at a sense be stuck, or not be moving in a particular way, and the team is looking for some way to enhance that movement, and the client realizing that something as profoundly simple as “My body is changeable.” The structure that I have is not necessarily the structure that I have to live with. So what I’ve come to in my forty years, or thirty-finer year, or fifty years of experience, doesn’t necessarily have to dictate the rest of my life that’s a miracle!” That in itself is a miracle, to have that level of understanding, I think.

There have been situations where I think that, my work is sometimes framed from the perspective of how the psychotherapist views it. So when coo talk about miracles a psychotherapist came to me the other week and Said, “You’ve had a more profound impact on helping this man to come to his identity than any other single aspect of this program.” I think what that was really saying is that helping this person to understand that their structure is changeable and could support them and that their body was able to look and feel different, giving this person a systematic process of unwinding, from some very old ways of looking at himself, helped him come to a new sense of his identity. It happened more in this are through the Rolfing experience than it did through the other components, so that was viewed as a sort of a miracle is you define miracle.

BH: I guess the most obvious question around this whole subject, maybe the first question I should have asked, is: You said you were working with people who were childmolesters, and people who in “society´s eyes are sick people, these are bad people. What kind of adjustment to your own compassion level did you need to make to be able to work with this population?

BS: Well, what I was realty clear about, was that I sometimes needed to use my own psychotherapy as supervision, as a way to get supervision about what was coming up in the sessions. I think there ire several things that have helped me to be More compassionate, and this is a little personal, but I’m fine with this, I experienced physical and sexual abuse in my childhood, and you might think that would cause me to he less available and more shutdown, but I think the work I’ve done on my own in the last ten years, and the work I’ve done to look at and discover about myself, has helped me to more present. The other thing that I´ve found is almost without exception, every client that I have worked with has been significantly sexually abused as a child himself every single one. And to look at the kind of impact that abuse has had on this person’s life is profound. To see the shutting down of the heart, or of the emotions or the way of just being in the World, to be so removed and so terrified… I don’t justify sexual abuse of children in any way and that’s not what I’m intending to do here, but I can see patterns of neglect and abuse that perpetuate themselves. This image of this child’s game where you have a hammer and you hit one peg down, anti another peg pops up, and you hit one peg down and another peg pops up. I think my hope is that there is a program that treats people who are sex offenders, not that just locks them away in prisons where they may ho abused again, and may be paroled to continue that abuse pattern. So I think those are the reason, and I also think I had remarkable instructors and teachers throughout my Rolfing; career that have helped me to translate what I understood psychologically into my own physical body, and then into being able to Work with other people’s physical bodies in ways where I could hold the space to let the person do their own work, and not have my own stuff intrude on it. That’s what I mean, that part of my being in my own psychotherapy has been really important, to keep my stuff separate from theirs really, really important.

There is one other thing I want to say. I think that we as Rolfers do a lot of this work a lot of the time any wav. The point that I think is important to make is that there are so many people being treated for one psychological disorder or another, who are going out with significantly compromised structures, maybe with lots of new awareness about their psychological process, but not a lot of new awareness about how their bodies might match that. Most of the work that I feel I’ve done here between me, the client and the psychotherapist, has been to talk about how that matching is important, to talk about how those meetings of discovery are important, so that it the person is advancing or understanding in his psychological process it they have a closed, shutdown, restricted, altered, torqued, rotated structure, it’s going to have something to do with how long they can sustain that kind of psychological information. One necessarily has to relate to the other.

BH: These psychologists that you’re working with, do they tend to be of a particular genre of training?

BS: No. This is not classic psychoanalysis, this is psychotherapy, so I would guess the primary twining would be Freudian based, some Jungian. I even want to clarity that, because I think some of the best people work nut of their training. What I mean by that is that they continue to grow, they continue to go through lots of continuing education and training, just as we do as Rolfers. For example, the whole question about how women are treated, how gays were treated in Freud’s early work, has come under a hit of lire and a lot of question, so mist of the people that I work with are amenable to looking at that Freud had a lot of good things to say but we need to move onto some other things, we need to gut beyond some of those early restrictions of sexism and homophobia and other sorts of things that were at play at that point in the culture. So I think the best psychotherapists that I work with are ones who are adept at change. I have been incredibly impressed with the skill and ability and sense of wonderment, and sense of wanting to get new information that has conic forward. And I think it’s directly related sometimes to psychotherapists not feeling threatened, not feeling like we’re trying to somehow usurp their authority or take away something from the discovery process that they would otherwise find. I’ve had a couple of therapists that I’ve had to work more closely with in terms of letting them know what I do and don’t do, and letting them know that this is not about ”stealing any of their thunder,” but it’s really about working with the client. I think 99% of the therapists that I work with absolutely understand that and are very clear about that, and are really welcoming and encouraging and available.

BH: Give me a sense of the scale. How big is the unit? How many psychotherapists are there to draw front, and how many of those are you actually interacting with?

BS: It depends on … I may see a client for a ten series, the client still stays in the program, because it’s longer than six months-I mean because the Rolling is less than six months, and the client is in there for six months. So I work with different ones at different times. But there are probably ten psychotherapists on the in patient team, there are 32 in patients at this facility-most of the time it’s full. There are differing levels of psychotherapy, whether it’s individual or group or psychodrama or art therapy, and numbers of others. There’s also an out patient department that sees a number of these patients, and is also a halfway house that helps in terms of people who are not ready after six months, who may need more work before they integrate back into wherever they’re going back to. So I see different ones and I work with different psychotherapists I’ve worked with most, I guess is the way to answer your question, at one time or other.

BH:…in the last four years. Wow, this is quite a story. Do You see that, or can you foresee that your efficacy in getting some kind of therapeutic results will he noticed by other similar facilities? Do you think that in ten years front now we’ll have these kinds of facilities calling the Institute and asking for people to conic and be on staff?

“the idea that a person can be in an intensive psychological process and in a sense be stuck, or not be moving in a particular way, and the team is looking for some way to enhance that movement, and the client realizing that something as profoundly simple as ‘My body is changeable.'”

BS: I think there arc two ways that that would happen, maybe more, but at least two. One of those is for people like me to get off my duff and start doing some outcome studies, and also to start writing articles and things like this, and other publications to let people know that it’s happening, so we can get a dialogue going. I’m sure there are other Rolfers in the country working with this, because to some degree we all work with this. I think really defining within the language of psychology, an outcome study that would begin Io look at certain criteria that I think could be measured. That would he a tough one, because part of it I think would be feedback from the client therapist interaction, and how that changes, so I think really the next step would be to try to define an outcome study, and start getting some tangible information. It can be done, because if a psychotherapist community can define outcome studies and measure their results, than certainly we can.

BH: Ain´t that the truth!

BS: So to answer your question, I think that what other fact lint’s who might be interested in doing this might be looking for would be some kind of outcome measurements, and some kind of feedback from the psychotherapist experiences. I think quantifying both of those would be helpful.

BH: This is fascinating stuff. How did you get this thing rolling?

BS: I started this program by meeting with the director of the in patent therapy program. I found out where the facility was …

BH: Wait a minute, you did this as a cold call? Or did you know him through some other process?

BS: No, I didn’t know him before, and in fact what I did was to work out (this may sound a little devious),I worked out a dinner party where I knew lie was going to be there. A friend of mine also knew him and I knew he was the in patient director. It started out by us spending what I thought would be about five minutes on a dialogue about why in-patient psychological programs don’t have some kind of bodywork component to them. That went on for about an hour and a half. From that point the invited me to talk to him again, I came for interviews with other members of the staff there to talk about what I do, and …

BH: That’s a pretty ballsy thing to do after being a Roller for a year!

BS: Yeah, well I thought it was too, but I had been a hospital administrator for 13 years.

BH: So you knew how to make a good impression.

BS: Not even so much a good impression, but I know how organizations work to some degree, so I knew that part of the way that I would get in here was by letting them know how I Would fit into their process, so I talked to them about how I would develop a billing form, for example, how I would work with the finance people to assure them that I wasn’t going to screw up their systems and that it could fit within that, and that I was basically a nice guy who was willing to work with them. It took six months (it that kind of work before I was even in the door. It was not a solid six months, but there was something to do every week for six months to get the thing going. It happened slowly. I started doing some massage with the clients, because the in patient team teas a little wary of what this Rolfing stuff was, and I Rolfed several of the therapists there before I Rolfed patients, and I think that was helpful in them understanding that I was not going to harm the patients there, I was not going to somehow injure them and that it was a safe thing to do. They didn’t know that, they had heard all the horror stories that other people hear about Rolfing, about how it’s painful and difficult, and I said it mold be. They asked me, “Is it painful?” and I said “Yes, it can be, it can he uncomfortable.” So we went through all that language about what is discomfort and what is pain, and I used their language, I guess is another way to put it, I talked about psychological discomfort, that this wasn’t a place where people were supposed to feel good all of the time; in order to grow, sometimes it required discomfort in order for that to happen. So that kind of thing, we did a lot of dialogue around that.

BH: And when you say six months before you got it going, does that include Rolfing the psychologists? How long from the moment you had the idea at the dinner party with this gun; or the moment you said something to him, to the time you actually started Rolfing the in-patients?

BS: Eight months. I was there two months before I did my first Rolfing session, after the first couple of months of doing sonic massage, getting the referral stuff going. I honestly started out, I would have one person, or maybe two people for the whole day, there just wasn’t much going, and I had to develop some level of trust.

BH: Did you wear these people down with tenacity, or how did this happen? Did you just “nice” them to death? What happened here?

BS: No, I think I probably did a combination of both, because the inpatient director, in a somewhat sarcastic way, would say how he respected my entrepreneurial skills. I think what he was saying was. “You’re pushing this so much that I’m going to say okay, but it’s because you keep pushing it” But I really felt that it was a very important thing to do, and I felt that the possibility was there, but it did not come easily. It was not that difficult, it just took persistence.

As it turns out now, the organization does the scheduling for me and provides the room for me so I basically go there and do my work.

BH: Well, congratulations on successfully getting it going.

BS: Thanks.

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