Diana Guest & Jan Parker
Bioenergetic Analysis • The Clinical Journal of the IIBA, 2021 (31), 39–47
https://doi.org/10.30820/0743-4804-2021-31-39 CC BY-NC-ND 4.0 www.bioenergetic-analysis.comThis article describes how bioenergetic therapists have had to adjust their clinical work due to the pandemic. We discuss factors to consider when working virtually or by telephone as well as the limitations imposed by the pandemic. Specific suggestions designed to assist the therapist in connecting, tracking, and working with clients are described. Ways to adapt bioenergetic techniques are included. We offer specific examples from the authors and our colleagues about how to adapt somatic interventions to the virtual environment. Additionally, therapist self-care, including ways to reduce Zoom fatigue, is addressed.
Keywords: videoconferencing, virtual environment, holding environment, bioenergetic techniques, self-care
Considerações sobre o trabalho bioenergético através de videoconferências (Portuguese)
O artigo descreve como os terapeutas bioenergéticos tiveram que se adaptar ao trabalho clínico durante a pandemia. Discutem os fatores a ser considerados quando se trabalha remotamente via virtual ou pelo telefone e as limitações impostas pela pandemia. Descrevem sugestões especificas uteis, para ajudar o terapeuta no contato, no tratamento e no trabalho específico com os pacientes. E trazem para os colegas exemplos de intervenções corporais no ambiente virtual. Eles ainda trazem sugestões para o auto cuidado do terapeuta, inclusive maneiras de lidar com o cansaço causado pelo zoom.
Consideraciones trabajando bioenergéticamente usando videoconferencia (Spanish)
Este artículo describe de qué modo terapeutas bioenergéticos han debido ajustar su trabajo clínico en pandemia. Discutimos factores a considerar cuando trabajamos virtualmente o por teléfono y las limitaciones impuestas por la pandemia. Se describen sugerencias específicas designadas para asistir al terapeuta en contacto, seguimiento y trabajo con pacientes. Se incluyen adaptaciones de técnicas bioenergéticos. Describimos ejemplos específicos de autores y colegas sobre cómo adaptar intervenciones somáticas al ambiente virtual. Le sumamos, además, auto-cuidado del terapeuta, incluyendo cómo reducir la fatiga provocada por el Zoom.
Considerazioni sul lavoro bioenergetico in videoconferenza (Italian)
L’articolo descrive il modo in cui i terapeuti bioenergetici hanno dovuto adattare il loro lavoro clinico per via della pandemia. Esponiamo i fattori di cui tener conto quando si lavora in remoto o via telefono e le limitazioni imposte dalla pandemia. Vengono descritti specifici suggerimenti utili ad aiutare il terapeuta nel contatto, nel tracciamento e nel lavoro con i pazienti. Vengono inclusi dei modi per adattare le tecniche bioenergetiche ed offriamo esempi specifici che ci vengono da autori e colleghi sull’adattamento degli interventi corporei nel lavoro in ambiente virtuale. Inoltre, viene affrontato il tema della cura di sé del terapeuta, compresa la fatica derivante dall’utilizzo di Zoom.
Suggestions pour le travail bioénergétique par vidéoconférence (French)
Cet article décrit comment les thérapeutes en Analyse Bioénergétique ont dû adapter leur travail clinique en raison de la pandémie. Nous discutons des facteurs à prendre en compte lors du travail par média informatique ou par téléphone ainsi que des limites imposées par la pandémie. Des suggestions spécifiques conçues pour aider le thérapeute à se connecter, à suivre et à travailler avec ses clients sont décrites. Des manières d’adapter les techniques bioénergétiques sont incluses. Nous offrons des exemples spécifiques des auteurs et de nos collègues quant à la façon d’adapter les interventions somatiques à l’environnement virtuel. En outre, la prise en charge du thérapeute par lui-même, y compris les moyens de réduire la fatigue associée à l’utilisation de Zoom, est abordée.
Dieser Artikel beschreibt, wie bioenergetische Therapeut*innen ihre klinische Arbeit aufgrund der Pandemie anpassen mussten. Wir diskutieren Faktoren, die bei der Arbeit im virtuellen Raum oder am Telefon zu berücksichtigen sind, sowie die Einschränkungen, die wegen der Pandemie verhängt wurden. Es werden spezifische Vorschläge beschrieben, die der Therapeut*in helfen sollen, mit Klient*innen in Verbindung zu treten, sie zu führen und mit ihnen zu arbeiten. Es werden Wege aufgezeigt, wie bioenergetische Techniken angepasst werden können. Wir bieten spezifische Musterbeispiele von den Autor*innen und unseren Kolleg*innen an, wie man somatische Interventionen an die virtuelle Umgebung anpassen kann. Zusätzlich wird die Selbstfürsorge der Therapeut*in angesprochen, einschließlich der Möglichkeiten, die Zoom-Müdigkeit zu reduzieren.
Когда приходится вести биоэнергетическую работу с использованием видеоконференций (Диана Гест и Йан Паркер) (Russian)
В этой статье описано, как биоэнергетическим терапевтам пришлось корректировать клиническую работу в связи с пандемией. Рассмотрены факторы, которые необходимо учитывать при работе он-лайн или по телефону, а также ограничения, налагаемые пандемией. Описаны разработанные нами конкретные предложения, призванные помочь терапевту в налаживании контакта, отслеживании процесса и работе с клиентом. В том числе способы адаптации биоэнергетических методов. Мы предлагаем конкретные примеры того, как адаптировать телесные вмешательства при виртуальном общении, от авторов и наших коллег. Кроме того, внимание уделено тому, как терапевт может позаботиться о себе, в частности, как снизить усталость от Zoom.
躯体动力分析视频会议的一些思考 (Chinese)
本文描述了躯体动力分析治疗师如何在新冠疫情下对临床工作做出调整。我们讨论了一些视频虚拟或电话工作的因素，还有由于疫情而引起的一些限制。给予治疗师在链接、跟进和与案主工作的方面一些具体建议。包括一些躯体动力分析的技术。作者和其他同事提供了具体的案例说明如何在虚拟环境中进行躯体干预。此外，治疗师的自我关爱，包括减少Zoom工作产生的疲惫等。
The COVID-19 pandemic has dramatically changed how people live. Most therapists have had to work virtually, by videoconference or telephone, for at least some segment of time, and may continue to have to do so for months longer. This article will discuss aspects of working virtually or by telephone, including topics to consider and ways to work bioenergetically in those formats. Most of us, as well as our clients, have had a significant change in our routine and schedule including the need to stay home to feel safe. This has resulted in increased time with children, partners, roommates, or other family members, working from home or not working at all. Additionally, the need for social distancing and wearing masks can lead to people perceiving others as unsafe. Due to this many people are experiencing an increased awareness of anxiety related to survival which was not present before.
One of our goals as Bioenergetic therapists is to help people live in reality and manage living with the unknown. Another is to experience joy and aliveness which is more difficult in our current environment. Our work has to do with being present with the client’s energetic presence, observing the body, working with the body, and often the use of touch as an intervention. However, when we work virtually the ability to feel the energetic presence is decreased, we are not able to see the whole body or if we do it is from a significant distance, and we are not able to use touch. Working on the telephone has its own limitations as well.
Some initial questions to consider when working virtually include: How do you feel someone’s energy? How do we create a new holding environment? How do we assist clients to feel their energy virtually? Does asking what happens when they see your face or hear your voice help their nervous system relax? How can the tone of our voice help regulate the other? and How can we feel connected to each other? These are some of the topics we will discuss further.
When working virtually “our minds are tricked into the idea of being together when our bodies feel we’re not. Dissonance is exhausting. It’s easier being in each other’s presence, or each other’s absence, than in the constant presence of each other’s absence. Our bodies process so much context, so much information, in encounters, that meeting on video is being a weird kind of blindfolded. We sense too little and can’t imagine enough. That single deprivation requires a lot of effort” (email from Helen Resneck-Sannes).
In preparing your clients for work online there are several factors to consider. It will be important that they are wearing loose clothing and have space in which they can move. Ideally, you want to ensure that clients have earphones and mics that allow them to hear well, talk freely, and move about the room. This could be using the computer microphone or having a wireless headset. It would be important to discuss this in the first session online. Another factor is understanding and dealing with the technology. Not all clients are familiar with how to use technology such as Zoom so this can be a learning curve for them. Sometimes the screen can freeze, and this could potentially impact the flow of the session.
It is important to inform your clients that staring at the screen and narrowing their visual field without a break can lead to increased fatigue. Whether you are working with Zoom, Skype, WhatsApp or Facetime, etc., it is important to begin your session by establishing safety for both you and the client. You may be entering the visual space belonging to the client, whether it is their home or office, and vice versa, for the first time. This changes the therapeutic frame and needs to be talked about. If you are in your office while you are working online are you sitting where the client will see the same background as when you are both there? If at all possible, for some clients, it would be important to set up your computer or other device so that the client has the same view as when physically in the room. Familiarity of surroundings is certainly a safety element.
Another aspect of safety is how close your clients want you to sit to the computer screen. This determines how much of you they can see. If you are sitting close to the computer and clients can only see your face it may be too much for some. If they are sitting close, they may feel “on the spot” while others may have difficulty discussing issues about which they experience shame. Some clients are more comfortable using the telephone because not being seen makes it easier to speak of things about which they feel shame. Other clients will want you to sit close so they can see the expression in your eyes and on your face. Additionally, both the client and the therapist need to have privacy during the session. This can be difficult if there are multiple people living in the same space. This must also be discussed. Once safety has been established the work can begin.
When working with clients virtually or on the telephone, it is important to consider how we maintain the connection, track the client, and communicate what we want them to do when we are not in the same room. For example, clients may lower their head and it may be difficult to tell if they are crying or laughing. You may need to ask clients what they are feeling in that moment without it feeling like a disconnect or that you are imposing something on them that you want them to feel. This may result in slowing the process.
When using videoconferencing it is wise to take a few moments for you both to get present to the new situation. One way to do so is to have clients close their eyes, breathe, and feel the chair. Next have them notice what they are feeling physically, and emotionally while their eyes are still closed. When working with new clients you may need to assist them in exploring their body sensations using prompts such as: Can you feel your back against the chair? Can you feel your buttocks on the chair? Can you feel your feet on the floor? Once they appear to be present with their body you can ask them to open their eyes and ask what their experience is of themselves. Then you can move into the work of the session.
If you have clients who are stuck in their head and talking fast in a live session you could put a hand on their knee or do some other physical action. It will take a different type of intervention online to interrupt that defense and some clients may have difficulty even hearing you when they are talking so fast. Therefore, saying “I need to stop you here because I want to hear all that you are saying” or pointing out the defense and obtaining agreement to interrupt can be interventions that may assist with those clients.
There could be a time when the use of a prop might aid in demonstrating what you want the client to do or as an educational tool. One bioenergetic therapist shared with us an example of a client who had an ongoing difficulty accepting or feeling her husband’s support when he would touch her. The client stated that her husband pats her back when he holds or hugs her. The therapist was aware that the client’s mother would do this when she was a small child to stop her from crying. So, when her husband does this it takes her back to this childhood experience. The therapist used a teddy bear to demonstrate how she can ask her husband to place his hands and refrain from patting so that she can take in the support. The therapist also asked the client to practice that touch with a stuffed animal or pillow herself.
There are many bioenergetic techniques that can be used in a virtual session. The first aspect to consider is how the volume of expression feels safe and acceptable to clients, considering their surroundings. One way to reduce the volume while hitting a surface to express anger is to use a towel folded in half and hit as they would with a tennis racket. Another way where clients can fully express sound is for them to put two corners of a towel in their mouth making sure that the tip of the corner is securely on their molars. They can bite down on the towel while using their voice to express the feeling that is coming up. Another common technique is to have clients scream into a pillow. This reduces the sound and facilitates the expression of anger or fear. Both of these techniques can lead to a deepening of affect and a sense of release. Clients can be surprised by the release and relief from emotional expansiveness and the pulsation/energy that is awakened in their body. It is important for them to also realize that the experience is real even though it occurs in a virtual session.
When clients go into a deep expression of emotion therapists can use their voice as a way to maintain the connection with the client. Once clients complete the emotional expression, it is even more important when working online to follow this expression with grounding techniques due to the barriers created when working in a virtual session. Each therapist needs to assess how comfortable they are taking their clients into deep emotional states while working virtually. Some therapists are more comfortable working by phone. Therapists who stated this commented that the voice never lies, and it is easier for them to assess the state of their clients in the moment. These therapists are more likely to be auditory processors and are thus more able to connect, assess, and track clients over the telephone.
Many interventions that can be used online include towel twisting, wall sitting, grounding, breathing, bow, exaggerating a posture, swinging arms around, stomping feet, the “get off my back!” exercise, moving eyes around, making different facial movements, squeezing a pillow, and hitting with a towel. These are all bioenergetic techniques that clients whom you have been working with will be familiar. However, they are also useful to introduce to new clients as deemed appropriate for deepening bodily awareness, helping clients to become more present, expressing emotions or for the purposes of grounding.
We can’t physically touch our clients, obviously, but we can still use touch in our sessions using different skills. You can begin with simple exercises, for example, getting them to place their hands on their body where they feel tension or emotion. Ask them what they notice as they do that. They can also breathe into the contact of their hands on their body. Listening to your voice while they feel that contact can facilitate a sense of not being alone. You could have clients hug themselves and imagine your arms, or some significant person’s arms, around them. Even though they are touching themselves it is being done in relationship to you and may bring up feelings from the past. What are they receiving from the touch? Is it support, a feeling of contact, or is it disturbing in some way? Ask them what their body needs in the moment and what they can give to themselves while remaining in contact with you. Therefore, it is important to use your voice to maintain the relationship and your presence during their work.
It will be important when working online to verbally process the work during the session and certainly as part of the closing section of the session. It is also important to help clients know that the experience and the relationship with you are real even though they are happening in a virtual session.
At some point when working online, clients may want to return to working face-to-face. Once there is a mutual agreement to do so there will still be new guidelines to consider. For example, both of you may be wearing masks. How does that impact the therapy? You may need to sit 6 feet apart as well. Both of these reduce the therapist’s ability to track the client in the same way we could prior to the onset of COVID-19. Another aspect to consider is the recommendation not to stay in an indoor setting for long periods of time. This may mean that sessions are held outside on a balcony or patio or that windows are open, both of which reduce the degree of privacy and expressive work. Therapists may no longer be willing to see clients back-to-back so that they can take a break and get outside or sanitize their office prior to the next client session.
Another important issue that will need to be discussed is a fear of touch resulting from the pandemic. First therapists have to reflect on what kind of touch, if any, in which they are willing to participate. Once that has been determined then therapists should have a conversation with clients to determine their boundaries around touch. It is important that both people are comfortable in re-establishing touch in the therapeutic process.
It is equally important to discuss the impact on the therapist of working virtually or by phone. This next section of the article describes several topics which therapists need to think about and plan. It is important that therapists feel competent and confident in whatever modality they are choosing to work in and to which they must adjust. For example, is the therapist an auditory, visual, or kinesthetic processer? Someone who is more auditory might work more easily on telephone and someone more visual online.
Another topic on which to reflect is that working virtually can lead to fatigue due to the need to focus on the screen, not allowing your gaze to change, not being able to hear the client well, potentially feeling more examined by the client due to the size of the face on the screen or feeling like clients are invading the therapist’s space if the therapist is working from home.
Some factors that can help are making sure that you have a comfortable chair that supports your back and that you sit so that you can breathe deeply and easily. It is important to set your screen so that you have plenty of space behind the monitor. You can face into a room or a window that does not get direct sunlight. This allows your peripheral vision to be more stimulated, allows your eyes to change focus which can reduce the fatigue factor. Avoid staring as that reduces the movement of the eyes and remember to blink frequently. Another helpful reminder is to move between focusing on the client in the foreground and the background behind the monitor or looking up at times. Moving in your chair, for example, using a gel pillow or sitting on a ball which encourages micro-adjustments will help keep the body alert.
It is equally important to stay connected to yourself which may require a different kind of focus than those used in the office. You are attempting to connect through a two-dimensional machine so it can be very difficult to both focus on the client and on yourself. The lack of an energetic connection in the moment may also contribute to the ability to stay present with the client and/or yourself. Our ability to somatically resonate is diminished and therefore we must draw on other internal resources to connect through the computer or the phone. Reflecting on how you maintain your sense of internal self in the office can also a key ingredient.
Given the facts of working virtually the need for therapist’s self-care is more essential than ever. Frequently checking in with your own energetic flow and scheduling clients to match that experience is also important. This may mean that you need to take more breaks in between clients or taking time off after a full day of sessions, thus working fewer days. Reflecting and doing the activities that nurture you is also an important part of self-care. Connecting with colleagues and friends also can be renewing.
The changes we have had to make are out of our control, and we have had to adjust in ways we have never experienced before. How do we stay true to what we know how to do as bioenergetic therapists while being constrained by having to work virtually? How do we adjust to this new normal? In some parts of the world working virtually may continue until there is a vaccine and most people have taken it. The challenge is that we value touch and working with the body. However, we have no choice but to work virtually or on the phone. Therefore, we must be vigilant in helping clients and ourselves remain embodied and energetically alive.
Diana Guest is a member of the IIBA faculty, is a current member of the BOT, and the past President of the IIBA. She is the Coordinating Trainer for SCIBA, New Zealand, and China training programs. She has been a local faculty member for 20 years. She is the co-author with Jan Parker of multiple journal articles, a book chapter and a book.
Jan Parker is a Certified Bioenergetic Therapist. She has been a professor at National University in San Diego for 26 years and is the co-author with Diana Guest of multiple journal articles, a book chapter and a book.