In an Unspoken Voice

by Peter A Levine

  The reason the bodily felt sense has the power to creatively influence our behaviors is precisely because it is involuntary; feelings are not evoked through acts of will. They give us information that does not come from the conscious mind. “Emotional intelligence” and “emotional literacy” communicate through the felt-sense/somatic markers and are vitally important to the conduct of our lives. Indeed, the writer Daniel Goleman139 claims that it accounts for eighty% of our success in life. However, emotions can also lead us astray.

  The Merry-Go-Round of Therapy

  When psychologists talk about change, they often equate it with insight. This assumption, though often subliminal, has had a profound influence on theories and therapies purported to help people deal with “mental” and “emotional” disorders. However, when we investigate this further, we see that understanding, talk and change frequently have little relationship to one other. Woody Allen, asked if he still had his same symptoms, quipped that he was only on his “fifteenth year” of psychoanalysis. If only he had known that the process of change has to do primarily with being able to alter one’s internal feeling states, and that “psychological” problems arise when these states have become habitual or “stuck.” These chronic emotional states in turn dominate our ways of thinking, imagining and behaving. An understanding of how deeply rooted feelings can change is at the core of any effective therapy. It is particularly germane to how traumatized individuals can begin to free themselves from the many behavioral reenactments and repetitive feelings of fear, numbness, rage, terror, helplessness and despair.

  The disparate roles of sensation, feeling and cognition in therapy have followed a convoluted and confounding path. At times emotions have been neglected, while cognition was esteemed. At other times, cognition has been dismissed, while emotions were practically worshiped. And most of the time, with very few exceptions, the therapeutic role of sensations has remained unknown. The balanced attention to sensation, feeling, cognition and élan vital (life-energy) remains the emergent therapeutic future for transforming the whole person.

  Freud, following his gifted teacher Charcot, initially believed that to cure neurosis, the patient must “relive” the painful (traumatic) memories that she had “repressed.” In addition, this reliving had to include a strong emotional component, a dramatic catharsis associated with the precipitating event. Employing this method, Freud came to believe that the precipitating event was frequently childhood molestation, usually perpetrated by the father on his daughter. (The vast majority of Freud’s patients were so-called hysterical women).

  Needless to say, Freud’s theory was not well received by the professional community, many of them doctors, bankers and lawyers. Most of them were fathers as well. From what is now known about the prevalence of sexual abuse, some of them almost certainly had been guilty of incest themselves. For this and other reasons, Freud backed away both from the seduction theory (as it was ironically labeled) as well as from his therapeutic method of uncovering repressed memories in order to relive them through strong emotional catharsis. In what must have been a profound betrayal to many of his patients, Freud began to interpret their symptoms not as deriving from sexual violation, but as being rooted instead in their childhood “oedipal” wishes, fantasies to have sex with the parent of the opposite gender. Freud may have also been unnerved when, during the intense cathartic reliving, patients would frequently transfer those (alleged) oedipal lusts onto him. Freud, with a discomfort in his own sexuality, appears to have shrunk from staying present with his patients’ confused, volatile sexuality and, thusly, betrayed them in yet another way. For these and other reasons, it appears that Freud abandoned the “hypno-abreactive” techniques in favor of free association to “help” the patient become conscious of their oedipal wishes and then to (somehow) sublimate these infantile “lusts.” In this way, Freud believed that by recognizing their fantasies, his patients’ neuroses could be transformed to “ordinary suffering.” A contemporary (Pierre Janet140) and a student (Wilhelm Reich) of Freud saw things differently.

  The Austrian-born psychiatrist Wilhelm Reich was convinced that his teacher had made a terrible mistake on two accounts. First, Reich believed that neurosis arose both from real events as well as from deep conflicts. Secondly, he was adamant that cure could only be realized when there was a powerful emotional release at the same time as the patient remembered a traumatic event. However, Reich went further than Freud in his treatment. He clearly recognized that the painful emotions evoked in reliving traumas had to be replaced (in the course of treatment) with deeply pleasurable sensations in order for health to be restored and maintained. Reich also believed that repression, of both the negative emotions as well as the pleasurable ones, was a physical reality, manifest in chronically tight and spastic muscles. These bodily restrictions caused constrained breathing and awkward, uncoordinated or robotic movements. He named this muscular rigidity character armor and perceived it as a mechanism having two unitary functions. While enabling the emotional component of the memory to be repressed, it also stifled the capacity to feel pleasurable sensations.

  Reich had a further conceptual breakthrough with the realization that one did not have to dig for traumatic memories as Freud believed. (This excavation was a central part of Freud’s free association treatment.) Rather, Reich’s therapy addressed the “body/character-armoring,” which had the function of freezing the emotions while maintaining the neurotic symptoms in the present. His therapy worked aggressively on two fronts. First, he brought the patient’s characterological defenses to their awareness by confronting their behaviors such as obsequious politeness or passive-aggressive hostility. In addition, he “attacked” the muscular armoring, directly, through vigorous manipulation and massage of the tight muscles. Reich also believed that the repression (the damming up) of adult sexuality was in itself one of the main causes of the neurosis. This is not dissimilar to Freud’s very early belief that “aktuelle” neurosis was the result of certain sexual aberrations such as masturbation and “coitus interruptus.”

  The end of Reich’s life was truly a national disgrace. In the sulfurous cloud of the McCarthy era, his books were burned by the FBI. Because of his radical ideas about sexuality, Reich was imprisoned for the trumped-up charge of violating interstate commerce laws. He died, in 1957, in the Pennsylvania federal penitentiary, an embittered visionary. With his death and Freud’s abandonment of both “real” trauma and emotional catharsis, the therapeutic interest in emotionality waned. Meanwhile, the movement toward behaviorism and rationality came into its ascendance. By the 1950s, such therapies as Skinnerian conditioning and Albert Ellis’s rational emotive therapy (RET) were dominating psychotherapy. (Incidentally, this therapy had very little to do with emotions.) The synergism of these approaches is now generally known as cognitive behavioral therapy (CBT). However, by the 1960s, the pendulum had begun to swing in the opposite direction. Emotions were finding their way back into the therapeutic community.

  Two of Reich’s patients (who later became his students) were Alexander Lowen and Fritz Perls. The first he referred to as the “uppity uptown tailor,” while the other he contrasted as “the dirty old man from the Bowery.”141 Both developed parallel extensions of Reich’s work, incorporating various aspects of his ideas and methods. While Lowen continued to emphasize emotional expression, and added the function of the legs in “grounding” emotions, Perls held to a more complex view of the organism. His therapeutic approach incorporated many ideas taken from the gestalt psychologies of the 1930s, 1940s and 1950s, including those of Wolfgang Kohler and Kurt Goldstein. However, in the anarchy of the 1960s, with its revolutionary disregard for rationality and the status quo, emotional catharsis was resurrected as a sure path to “liberation” and “freedom.”

  However, this process of emotional abreaction can become a self-perpetuating mechanism by which patients crave further “emotional release.” Unfortunately, this process moves into an ever-tightening spiral that f
requently culminates in a therapeutic dead end. Such was the case, for example, in the 1970s, when Arthur Janov promoted his primal therapy. (Reich had warned his contemporaries about mindlessly using emotional catharsis, pejoratively calling its promoters “freedom peddlers.”) “Neo-Reichian release,” “encounter groups,” “primal therapy,” “rebirthing” and other dramatic therapies co-opted the staid preeminence of the “talking cure” with an exuberant expressive zeal. Presently, at the beginning of the third millennium, we are seeing an emerging synthesis, a movement toward a more balanced emphasis on emotion and reason. In particular, experiential therapies are emerging, such as those described by Diana Fosha and others.142 These include dialectical behavior therapy and acceptance and commitment therapy (ACT).

  The ability to effectively contain and process extreme emotional states is one of the linchpins both of effective, truly dynamical trauma therapy and of living a vital, robust life. While love can sway us off our feet, powerful emotions like rage, fear and sorrow can pull our legs out from under us. We can be driven nearly insane by rage, paralyzed by fear and drowned by sorrow. Once triggered, such violent emotions can take over our existence. Rather than feeling our emotions, we become them; we are swallowed up by these emotions. This can be quite a dilemma because being informed by our emotions, not domineered by them, is crucial in directing our lives. We may have too much or too little; they may come upon us like a torrential flood or leave us dry like a parched desert. They may lead us in a positive direction or cause us untold suffering. They may prompt creative exultation or may provoke disastrous actions and poor decisions. They can lift us up or tear us down. No matter what the case, most of us realize that emotions (whatever they are) play a central role in the conduct of our lives.

  The key to not being swept away by intense emotional states is to catch them before they ignite and inflame us. The Buddhists have an expression for this: to “cool and extinguish the glowing embers before they ignite into a consuming flame.” Constraint allows us to tame and befriend emotions so that we may be guided by them. It is the way we can become aware of our emotional undercurrent before it becomes an out-of-control emotion. The tools that allow us to do this are the twin sisters of awareness and embodiment.

  As people learn to master their emotions, they also begin to harness the underlying impulses to action. For example, underneath the emotions of rage and anger are the impulses of aggression. Healthy aggression is about protecting ourselves and those who are close to us. It is also about setting clear boundaries and getting the things we need, including food, shelter and mating partners. It is what empowers our lust for life. This passion for life must be supported by a capacity to embody a range of purposeful emotions. For now, let us back off and ask the following question: What is an emotion, anyway?

  “Qu’est ce qu’une émotion?”

  Binet posed this very provocative question at the dawn of the twentieth century.143 He opened the debate with a salvo that eludes a solution even to this day, despite the most vigorous of arguments. Simple to ask, though difficult to answer, the question remains: What the heck is an emotion?

  Theories of emotion, abundant and diverse, have had a long, twisted, confounding and often-contradictory history. They have been grappled with in turn by philosophy, psychology and evolutionary biology. Each of these disciplines has attempted to define, refine or, simply, understand emotion.

  “Emotion as a scientific concept,” wrote Elizabeth Duffy, the matriarch of modern psychophysiology, “is worse than useless.” On the basis of extensive physiological recording, she felt that there was no way of differentiating one emotional state from another. In other words, distinguishing an emotion solely on the basis of physiological measurements (e.g., heart rate, blood pressure, respiration, temperature, skin conductance, etc.) seemed impossible. Thus, emotions, from her vantage point in 1936, were unworthy of scientific study. Yet recently there has been a rich vein of inquiry and grounding in the emerging field of the “affective neurosciences,”144 demonstrating distinct brain systems involved in the expression of various emotions (e.g., fear, anger and sadness). However, the question of felt (as opposed to expressed) emotional experience has been all but neglected. Psychology, questing for objective respectability, has attempted to purge subjectivity from its midst. It has, in the process, unwittingly thrown out the proverbial baby (the subjective feeling experience) with the bathwater by studying primarily the expression of emotion.

  Much of philosophy and early psychology were of the logical, “common-sense” conviction regarding the sequence by which an emotion was generated. Today, like the early philosophers, we resort to similar explanations. For example, when something provocative happened to René Descartes (perhaps someone raised his fist and called him a jerk or alternatively patted him and told him, “You’re a great guy”), he might have believed that his brain recognized this provocation as being worthy of an emotional response—anger, fear, sadness or elation. Had the physiology of his times been more advanced, he would have interpreted the next step as his brain telling his body what to do: increase your heart rate, blood pressure and breathing; tense your muscles, secrete sweat and/or make goose bumps. These are responses controlled by the autonomic (involuntary) nervous system, preparing the organism for various actions related to fight or flight. For Descartes, and for most of us, this sequence makes perfectly logical sense and seems to describe how we experience emotion.

  At the turn of the nineteenth century, however, William James, who had studied with the experimental psychologists of his time, took an experiential, rather than philosophical and speculative, approach to the study of emotions. James would set up imagined situations, such as being chased by a bear, and then through experiential introspection would attempt to infer the chain of events by which an emotion, such as fear, was generated. In these subjective experiments he would sense into the interior of his body, as well as noting his thoughts and internal images. Ultimately, he arrived at a rather unexpected conclusion. Common sense dictates that when we see a bear, we are frightened, and then motivated by fear, we flee. However, in his careful, reflective observations, James concluded that rather than running because we are afraid, we are afraid because we are running (from the bear). In James’s words,

  My theory … is that the bodily changes follow directly the perception of the exciting fact, and that our feeling of the same changes as they occur is the emotion. “Common sense” says we lose our fortune, are sorry and weep; we meet a bear, are frightened and run; we are insulted by a rival, are angry and strike. The hypothesis here to be defended says that this order of sequence is incorrect, that the one mental state is not immediately induced by the other, that the bodily manifestations may first be interposed between, and the more rational (accurate) statement is that we feel sorry because we cry, angry because we strike, afraid because we tremble.145

  This counterintuitive (bottom-up) view challenged the Cartesian/cognitive (top-down) paradigm where the conscious mind first recognizes the source of threat and then commands the body to respond: to flee, to fight or to fold. James’s bottom-up perception—that we feel fear because we are running away from the threat—while only partially correct, does make a crucial point about the illusory nature of perception. We commonly believe, for example, that when we touch a hot object, we draw our hand away because of the pain. However, the reality is that if we were to wait until we experienced pain in order to withdraw our hand, we might damage it beyond repair. Every student of elementary physiology learns that there is first a reflex withdrawal of the hand, which is only then followed by the sensation of pain. The pain might well serve the function of reminding us not to pick up a potentially hot stone from the fire pit a second time, but it has little to do with our hand withdrawing when it is first burned. Similarly, every student of basic chemistry learns, hopefully after the first encounter, that hot test tubes look just like cold ones. However, what we falsely perceive, and believe as fact, is that the pain causes u
s to withdraw our hand. James was able to perceive that fear was not a primarily cognitive affair, that there was a muscular and visceral reaction in his body first, and that it was the perception of this body reaction that then generated the emotion of fear. What James observed was that, yes, when the brain calculates that there is danger, it makes this assessment so quickly that there isn’t enough time for the person to become consciously aware of it. What happens instead, according to James, is that the brain canvases the body to see how it is reacting in the moment. In what was a revelatory revision, James relocated the consciousness of feeling from mind to body. In doing this he demonstrated a rare prescience about what neuroscience was only to begin to discover a hundred years later.

  Ben Libet,146 neurosurgeon and neurophysiologist at the University of California–San Francisco’s Medical School, conducted a revealing, but little known, series of studies over thirty years ago. He essentially confirmed James’s observational chain. Here’s a little experiment that you can do right now. Hold one of your arms out in front of you with your hand facing upward. Then, whenever you feel like it (of your own “free will”), flex your wrist. Do this several times and watch what happens in your mind. You probably felt as though you first consciously decided to move and then, following your intention, you moved it. It feels to you as though the conscious decision caused the action.

  Libet asked experimental subjects to do just this while he systematically measured the timing of three things: (1) The subjects “conscious” decision to move was marked on a special clock. (2) The beginning of (what is called) the readiness potential in the motor cortex was measured using EEG electrodes on the scalp. (3) The start of the actual action was measured using electrodes on the wrist. So which do you think (based on your experience in the preceding experiment) came first? Was it the decision to move, activity in the motor cortex, or the actual movement? The answer, defying credulity, dramatically contradicted common sense. The brain’s activity began about 500 milliseconds (half a second!) before the person was aware of deciding to act. The conscious decision came far too late to be the cause of the action. It was as though consciousness was a mere afterthought—a way of “explaining to ourselves,” an action not evoked by consciousness. As peculiar as this might seem, it fits in with previous experiments that Libet did on exposed brains as part of a neurosurgical procedure. Here, Libet had demonstrated that about half a second of continuous activity of stimulation in the sensory cortex is needed for a person to become aware of a sensory stimulus.147 I had the opportunity to watch one of these procedures, and it was jaw-dropping to see it on the oscilloscope.