EMDR and the Energy Therapies: Psychoanalytic Perspectives (Book Review)

Author:  Mollon, Phil
Publisher:  Karnac
Reviewed By:  Judith Issroff, MD, Winter 2006, pp. 59-62

Phil Mollon is an experienced, dedicated psychoanalyst and clinical psychologist of courage and creative integrity. He is an unusually open-minded, careful, scholarly and integrative thinker and practitioner. His ninth book is without doubt of great importance because it represents a therapeutic turning point in the history of psychoanalysis – and in more than psychoanalysis for the number of traumatized people whose suffering the revolution in practice it foretells will surely alleviate. More than that, it is a book that takes a level look at complacent “accepted” and “here and now” relational psychoanalytic practice, and questions the assumptions that have become dislocated from original basic Freudian theory and practice.

Traumatologists (Van der Kolk 1993, Rothschild 2000, 2003) and neurophysiological pathologists today have no doubts about what can neither be symbolized nor told, that is the bodily encrypted basis of trauma memories and their programmed re-enactments that Freud depicted as the “repetition compulsion.” In her near unreadable, dry, but highly significant compendium of research evidence, Bradley (2000) demonstrated that affect regulation is the final common pathway of diverse methodologies for effective therapeutic action. In his monumental synthesis of data, compellingly well researched and written, Allen Schore (1994, 2003a,b) has further documented these findings. It is by processing the affects bound up in traumatic bodily-encoded memories that free association is facilitated and traumatic memories rendered accessible to narration without re-traumatization from the re-experiencing of overwhelming inadequately regulated affect originally experienced.

No one can ignore these contributions. Similar conclusions are derived from a quite different and fundamentally psychoanalytic perspective by Philip Bromberg (1998): in his accomplished critical overview of psychoanalytic theory) Bromberg convincingly argued a trauma-dissociation-affect regulation model for psychoanalytic understanding of personality development, psychopathology and therapeutic process. Mollon’s synthesis demonstrates how the remembered psycho-physiological underpinnings of such traumatic states are reactivated and how these states can be dealt with. Along the way he provides a fascinating articulation of core contributions of many pertinent psychoanalytic thinkers from Kohut to Lacan, Winnicott, Bion, Klein, and takes issue not only with Betty Joseph, but also Peter Fonagy’s relational style of analysis.

Mollon also takes a serious look at a sweep of ancient body energy practices such as acupuncture, shiatsu, and chi gong, along with recent therapies like EMDR (Eye Movement Desensitization and Reprocessing, Shapiro 1989, 2001), and TFT (thought field therapy) for treatment of post traumatic states. Their sometimes startlingly rapid effectiveness is solidly evidence-based: at the simplest level, neurologically they are known to link right and left brain (Schore 1994, 2003a,b). With his gift for grasping and succinctly elucidating the nub of a concept, Mollon compellingly demonstrates how their theoretical underpinning is found in Freud’s original 1894 Project and its later exegesis. With discerning quotations he leads us through and back to basic Freud. After reading this almost mathematically convincing section linking the energy therapies to classical Freud, I felt like exclaiming “Q.E.D.”

One can say of very few books that it might be irresponsible for a serious practitioner not to familiarize him or herself with it. Yet I cannot but call Phil Mollon courageous, for undoubtedly the book will arouse resistance and scepticism in the psychoanalytic world. Far too many dogmas of belief in what constitutes accepted contemporary “good” practice in psychoanalysis are challenged for an unquestioning acceptance of Mollon’s convincing and straightforward attack on what he perceives and demonstrates to be an over-emphasis of focus on partial countertransference interpretations and often inappropriate and ineffective “here and now” interpretation .

Clearly current practice has deviated in many ways from Freud’s original evidently accurate observations and theoretical inferences, including the nature of transference proper. Mollon tackles this problem by taking apart a “model” case study published by Betty Joseph (1985) to provide an alternative analysis of how the material can be understood (pp.82-91). It is difficult not to be persuaded by the stronger case Mollon makes. Especially because Michael Balint, who supervised my first psychoanalytic training case, used to caution: “Like polo neck sweaters and mini-skirts, currently transference interpretations are in fashion. But consider, are they always appropriate to the weather?” Mollon makes the same point arising from his psychoanalytic understanding of how the energy methods work and a close look at Freud’s original theory. He provides extremely clear and convincing case studies of his sage combination approach to defusing traumatic affects using the energy methods, thus improving the patient’s ability to free associate without increasing resistance by abreactive, overwhelming and often re-traumatizing memories. One readily follows how his application of these techniques is tempered astutely and guided by his psychoanalytic knowledge. In fact it is clear that Mollon is not describing a simple instant “feel good” and apparently generally lasting “cure,” but rather advancing the view that the deeper gains made during the process of liberating understanding, symbolization and verbalization that psychoanalysis facilitates, can be acknowledged once the bodily encoded memory states no longer interfere with the defensive states against recall. Thus, once emotional desensitization has been achieved, the body-based techniques free the symbolic cognitive processes necessary for analysis by permitting changes in the way memories are processed, allowing for conscious recall of the “repressed” traumatizing experiences.

Mollon also uses his psychoanalytic knowledge to understand the “negative therapeutic reactions” that are sometimes encountered in patients treated with the energy therapies. It is clear that practitioners in these fields will become better equipped by studying the psychoanalytic conceptual tools that Mollon brings to bear on their work.

George Allyn told me how Winnicott asked him to obtain some authentic Buddhist wisdom texts to send to a jailed adolescent who had phoned him from prison to ask for help. Winnicott commented: “They have helped people for thousands of years and he ought to find something in them to help him.” It should come as no surprise to us that analogous concepts to those basic to psychoanalysis are found in ancient practices, in particular traditional Jewish thought and traditions with which Freud was most certainly familiar (Steinshaltz 1960; Yerushalmi 1993; Drob 2000; Berke, Schneider 2003). Energy notions are at the core of ancient and tried Chinese “medical” practices such as chi gong, so, while having one of my regular shiatsu treatments, I mentioned Mollon’s book to my “master” practitioner friend, Ken Waight . He proceeded, in his language, to treat me to a fascinating exposition that had many meeting points with those Phil Mollon put forward in his psychoanalytic-cum-body energy discourse. I select some significant points Ken Waight highlighted:

· In Chinese medicine there are points called Dragon points and ghost points.
· Dragon points are points related to emotions in the body and ghost points relate to the presences of past experiences that reside within us.
· When we work with our bodies we need to find resolution to problems with our past experiences and present manifestations of the energy of those experiences.
· The emotions have powerful physical aspects that manifest through the body very strongly--the Dragon points--and because of that, they are good to work with in movement therapy, or music, or art, or even in meditation because they are so strong.
· Ghost presences are much more difficult because they are invisible presences that have no one particular or strong apparition: a ghost can clothe itself like the mist, can evaporate in the sunlight and come back in the evening--it lingers.
· When people have had very strong traumatic experiences, when they dissociate and create these alter personalities or people within them, it becomes very difficult to connect to the ghost presence. It is difficult to contact because the person will ‘clothe’ the vulnerable hidden core and put another presence in front so it is difficult to connect to the ‘naked self’ because you will always come to one of these defensive protective personalities.
· To a lesser or greater extent, as I’ve learnt through meditation and body movements, we all have a number of selves which we call ‘the self’--‘the ego’ if you like--but it isn’t one fixed one, it is an idea, a condition which we form together with our environments to call ‘the self.”
· To people in general just being alive is traumatic because birth pulls us all over the place . We create all kinds of mechanisms in order to survive and these are like extensions of the ego: they help us to survive and control our environment so what we call our ‘self’ can survive.
· But with people who have deep traumas these protective mechanisms are extended personalities and are much more fixed and stronger as extended presences. So when you are with someone who has this condition, it is very difficult because you might be working with one personality and talking to that personality and the other personality might not even be hearing.
· With body movement you see this by a lack of being able to inhabit the body or completely inhabit it- people like that can either be in their body or completely disconnected. They can be like ghosts… and because they are not aware of the link to their extended personalities, they can never find the connection to the ghost body to touch that. [Comment: I think we can all translate to our own metaphoric terminology of “depersonalization” and “derealization”]
· Ken Waight continued: I think that in most therapies they become the ways in which they help us to get along in life, learn a new skill. It is like riding a bike, as you learn you get on one, fall off a few times, and get back on till you have a feeling of how to do it. Then, more or less, you can do that for the rest of your life. And many therapies, meditation practices, movement practises are like that – they’re ways to help us get along. But maybe even a practitioner never learns to throw away the crutches. It is like jazz musicians who are jugglers or tinkerers, who have the skill to put things together but cannot completely be free enough to improvise creatively.
· The skill has closed them rather than opened them, and they haven’t gone far enough. It is just like when we form patterns in our body in order to learn something or do something, and they then become mannerisms deeply ingrained into our body structure, and they take on anatomical and psychological structures that are fixed in our bodies and our behaviours, and beliefs and their ways. It takes skill and wisdom and a high level of proficiency not to be a juggler but to be able to work spontaneously in the moment to connect with someone and be in contact: you need yourself to be able to be flexible enough and improvise and move in order almost to outwit or out-manoeuvre the presences fixed in the client….
· Working with the ego is like shadow boxing. It’s like you’re trying to hit something that is moving with you--difficult. You have to find a stillness--and awareness where the shadow and boxer can be separated.

Mollon has arrived at very similar conclusions using different metaphoric language derived from psychoanalysis and from his experience with personality disordered highly traumatized clientele. He clearly has no illusions about the difficulties many psychoanalysts will have in coping with the theoretical and practical implications of his work. He even devotes part of a chapter to discussing cults and comparing some psychoanalytic group rigidities to cultists who are defending against disintegrative anxieties. Such analysts will continue to hold with religious conviction to their theoretical and current fashionable “accepted good practice” crutches and will persist in pedalling their bikes clothed in their self-fulfilling assumptions and beliefs with the same resistance to change as their clients, who are disabled by their repetition compulsions and defensive manoeuvrings.

Fonagy (2004, p. 1503) has argued that “as psychoanalysts engaged in the alleviation of suffering, it is our ethical obligation to make use of all the sources of knowledge at our disposal, and in any event an integration across disciplines is already well under way and probably unstoppable, as evidenced by Demasio’s keynote address” at the New Orleans International Psychoanalytic Congress. Etchegoyen commented that neuroscience, attachment theory and other voices outside of the psychoanalytic mainstream can be “taken as enriching, rather than detracting from psychoanalytic knowledge” (2004, p.1503). These comments are cogent and applicable to Mollon’s work: it restores Freud’s earliest work to its central and dominant place in psychoanalysis. It should have a major impact on psychoanalytic technique. Without doubt it merits major attention as a groundbreaking contribution.

References

Berke, J.H., & Schneider, S. (2003). Repairing worlds: An exploration of the psychoanalytical and kabbalistic concepts of reparation and tikkun. Psychoanalytic Review, 90(5), 723-749.
Bradley, S.J. (2000). Affect regulation and the development of psychopathology. New York: Guilford.
Bromberg, P.M. (1998). Standing in the spaces: Essays on clinical process, trauma, and dissociation Hillside, NJ & London: The Analytic Press.
Drob, S. (2000). Freud and Jewish Mysticism: Kabbalistic metaphors. New York: Jason Aronson, pp.241-288.
Etchegoyen, H. (2004). Reported by Vorus, N., & Wilson, A. (2004), p.1503.
Fonagy, P. (2004). Reported by Vorus, N., & Wilson, A. (2004), p.1503.
Heimann,P. (1950). On countertransference. International Journal of Psycho-Analysis, 31 60-76.
Rothschild, B. (2000). The Body Remembers: The psychophysiology of trauma and trauma treatment. New York, London: W.W. Norton.
Schore, A.N. (1994). Affect Regulation and the origin of the self: The neurobiology of emotional development. Hillsdale, NJ & Hove, UK: Lawrence Erlbaum.
Schore, A.N. (2003a). Affect Dysregulation and disorders of the self: The neurobiology of emotional development. Vols.1 & 2. New York: W.W. Norton.
Schore, A.N. (2003b). Affect regulation and the origin of the self: The neurobiology of emotional development. New York: W.W. Norton.
Shapiro, F. (1989). Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories. Journal of Traumatic Stress Studies, 2, 199-223.
Shapiro, F. (2001). Eye movement desensitization and reprocessing. (2nd ed.). New York: Guildford Press.
Steinshaltz, A. (1960). Hassidim and psychoanalysis. Judaism, 19(3), 222-228.
Van der Kolk, B.A. (1994). The body keeps the score: memory and the evolving psychobiology of post-traumatic stress. Harvard Review of Psychiatry, 1, 253-265.
Vorus, N., Wilson, A. (2004). Conceptual frontiers: Representation and object relations, International Journal of Psychoanalysis, 85, 1501-4.
Yerushalmi, Y.H. (1993) Freud´s Moses: Judaism terminable and interminable. New Haven, London: Yale University Press.

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