In Service of the Self: A Psychosomatic Paradigm

By: Ursula Stehle, Ph.D.

Earlier this year I spent several weeks in Germany to be with my family but also to see how Europeans address psychological healing, and how it has evolved since I left twenty years ago. I visited the Filder Clinic in Stuttgart, and two psychoso­matic clinics in Freiburg: the Friedrich Grodeck Clinic, and the Psychosomatic University Clinic. The Filder Clinic is a private general hospital that offers medical and therapeutic services ex­tended to include anthroposophical treatments. What was striking to me, when I compared the three hospitals, was not their differ­ences but their similarities. All three used art and movement thera­pies to support the healing process. In my conversations with practitioners I learned that both psychological and medical treat­ments have come to incorporate expressive therapies in their canon of offerings. All three hospitals have embraced an understanding of disease as rooted in body and soul, and all three hospitals consider their treatment psychosomatic. In Europe, the term 'psychoso­matic' means originating in both psyche and body. In the US, the same term generally implies that one's physical symptoms are gener­ated in the mind and therefore made up, and not real. However, the term currently is undergoing redefinition as practitioners and scientists reevaluate and re-vision healing.

Over the past five to ten years, neurologists have discov­ered that body and mind are not separate, finding that emo­tional experiences affect every organ and tissue in our body. Our proverbial "gut feeling," or "broken heart" are no longer metaphors alone but have a physiological basis. Emotions mani­fest not only in our mind but in our organs, intestine, limbs, and skin. With this research science affirms what we have al­ways intuitively known, that the human being is a totality of body and mind. Chronic physical symptoms and illnesses, al­ways have deep roots in emotional experience, and psychologi­cal/psychiatric problems are not strictly the domain of the mind but always also manifest as bodily symptoms.

How do psychotherapy, art, movement, and meditation support mind/body integration? In meditation, we observe feel­ing responses without changing, judging, or attaching to them; in movement therapy we pay attention to movement and con­scious gesture, expressing inner experience in time and space; and therapeutic art directly works with our senses and feeling responses. Aside from its diagnostic function, therapeutic arts bring unconscious feelings to consciousness. Feelings locked in the body without conscious voice may have become expressed through symptoms.

In psychotherapy, through genuine relationship and the meta­phoric use of language, we again become aligned with the central organizing force within us, our Self or Ego. The capital letters here refer to an inner organizing principle that allows us to remain con­nected to our individual destinies, not to the short-term gratifica­tions of self. When we become aligned again with our Self/Ego, we free our feeling life from the blockage of judgment, and emotional expression again can function as a riverbed that connects and com­municates between body and mind.

Mainstream psychiatric, and to a lesser degree psychologi­cal therapies have increasingly embraced a "broken brain" para­digm, with the result that emotional problems have been primarily seen as chemical imbalances and dysfunction. Our minds and souls have been reduced to bodily functions, and became mired in matter. Substances in the form of Prozac, Lithium, Xanax, and others are given to fix these imbalances. However, not only is the response to these drugs limited, they also carry significant risks that need to be carefully weighed, before a per­son embarks on interfering with the complicated and intercon­nected biochemical balance in our brains and bodies.

In my psychological practice, therapists are generally com­mitted to taking a path of least intrusion in their efforts to bring understanding and health to the individual. The path of least intrusion suggests that we first approach a condition or prob­lem by attempting to understand what may have caused the symptomatic reaction. It further explores, how the specific symp­tom expression can be understood in the context of a unique and important life that is striving toward becoming more healthy and whole. The therapeutic process of expansion, meaning ac­tive exploration and making conscious that which has lived deeply hidden within ourselves, is complemented by dynamic contraction, which includes holding, valuing, and observation of emotional content.

Both movement and art deepen the processes initiated by the psychotherapist by making previously unconscious material accessible to our senses. just as we have given up our own cre­ative talents, in the face of the perfection that media images and movie stars offer us, so have we often given up our own individual and subjective experiences to culturally desirable ones. As we struggle to express ourselves through an artistic medium, we use our senses in a new and fresh way. In this way we are all artists.


Ursula Stehle, Ph.D. is a clinical psychologist in Fair Oaks, Califor­nia. She is committed to supporting the body through natural medicines, the soul through artistic and psychotherapeutic offerings, and the human spirit through the quality of the therapeutic environment. Dr. Stehle holds diplomats in psychopharmacology, and severe mental illness, and is Assistant Professor at the Professional School of Psychology in Sacramento. She can be reached with questions and comments at her e-mail address: