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Origins and History of Pesso System/Psychomotor Therapy
This is Part Three of the Article by Louisa Howe, Ph.D.
 Returning to Diane's account of her experience with her psychiatrist and the ultimatum he had given her about doing "that type of thing,"
I told him that I wouldn't do any more before I came in for the next appointment. When I next arrived, I said I had chosen the movement work, but that I thought the two together would be best and really wanted to continue working with him. He suggested I wait to complete my work with him, and when I told him I had decided not to wait he told me that I would be back. I never went back. All those needs that got put on him, the effect of the transference... I learned to hate the effects of transference... the less transference there is to the therapist, the safer and better (Note 2). Subsequently, I have always emphasized getting the transference off the PS therapist and onto the roleplayers as soon as possible. I believe in the power of the caring part of human beings, the therapist and the other clients, but using transference on the therapist as part of the therapy is fraught with danger, provides no opportunity for reality testing and is bad for the therapist who can't behave as his or her imperfect real self (Note 1). Diane remembers that around this time she and Al had visited Charles and Elaine Pinderhughes at their home, and that Elaine's supportive reaction to her situation was very helpful as she struggled to deal with this abrupt termination of her therapy (Note 1). Diane's recollections concerning the first Psychomotor structure, that occurred one week after the improvisation connected with her grandfather's funeral, are as follows: Al suggested I try doing direct emotional expression from the species stance. I started moving with anger and Al got somebody to stand in to respond as if the anger was effective. As the anger was expressed I realized that it was my father I was angry at, so that person was now standing in for him. When my anger was over I was left with the still unsatisfied emotional need that had caused the anger, and the wish for my father to behave differently. Al and I were perplexed about what to do about this. We knew it wouldn't make sense to change the behavior of my real father because that wouldn't be true; there was no way of changing his past behavior in the current situation. But the need was very strong and was directed toward that figure. We wanted that need satisfied and we looked for ways to make it happen. I knew that other parents, if I had been their child could have treated me differently. We came up with the idea of someone represent a brand new father. Then the problem was for me to get my child self to give up trying to get needs satisfied by my role-played "real" father and to turn my needs toward my "new" father. I did so and it was wonderfully satisfying (Note 1). Al and Diane thus began to recognize that two kinds of figures were needed: a responsive target for the satisfying expression of anger and a strong, positive figure who could provide an antidote for past hurts, deprivations or losses. This they saw as a bodily as well as a psychological need. Since early negative experiences very often had to do with parents, the polarized figures were likely to be designated respectively as "bad" mother or father and "good" or "wished-for" father or mother. The "good" parents not only counteracted the influence of the "bad" parents but also were a source of acceptance, support, and validation, that were especially needed after a "bad" parent or other figure had been symbolically attacked through angry gestures and vocalizations. Knowing that accommodating responses would occur made it easier to express emotion spontaneously. This expression in turn helped structure enactors to summon up recollections of events in childhood which were still charged with their original emotional meaning, even though the events and feelings might have long been absent from conscious memory. These early, remembered events usually set the stage for the structure that would then be enacted. From the development of accommodation to the enactment of structures was a short step; one led almost irresistibly to the next. Training was necessary for the negative accommodators who represented "bad" figures: they were not to retaliate, nor defend themselves, but were to let themselves be defeated, responding to each angry sound, statement or gesture with a body movement and vocalization modulated to match the intensity of the attack against them. Structure enactors were repeatedly reminded of the "four foot rule": the "attacker" was to maintain a distance of at least four feet from the person being "attacked" by hand and arm gestures or by kicks. Also useful for structures were exercises, originally designed for dancers, that sensitized participants to other people's locations -- whether nearer or farther away, whether standing higher or sitting lower than one's self, whether located in front, in back, or by one's side -- and what the significant feelings were that these positions evoked, to say nothing of how it felt to have an "accommodating" person faithfully follow one's bidding. Thus exercises designated as "controlled approach" and "stimulus figure" were performed, as well as various circle exercises which emphasized the difference between inner and outer, and between acceptance and rejection. (These exercises are described fully in Movement in Psychotherapy, 1969). Positive accommodation in PS/P structures was modeled on the normal, healthy kinds of physical contact that occur between parents and children in the real world. Parents could touch children in caring, non-sexual ways; members of the group could accordingly touch each other in ways that were equally non-sexual when they were enacting structures or serving as accommodators. Diane was more easily able than Al to voice the belief that what they had discovered and created together was the foundation for a new method of psychotherapy. Al had always been the more psychologically-minded and theoretically oriented of the two, and would have liked nothing better than to think that what they were doing could be considered an advance beyond existing methods of psychotherapy. This seemed, however, to be more than he dared to hope for. Dancers they trained had started to do structures and had been surprised at the lessening of their tension and anxiety and the improvements in their performance. According to Al, "Diane was the one who believed all the way through, while I found it hard to say such things aloud. I said, 'We can't be doing what we seem to be doing; we can't be!' and Diane said serenely 'We're doing it'" (Note 2). First Version: Early to Mid-'60s At the time of my first contacts with Al and Diane and with PS/P the essential elements already described were well in place, although some things were quite different from what has since evolved. First, it was considered to be "non-verbal", a designation that in the l990s would hardly seem apt, even though the underlying emphasis upon spontaneous emotional expression through movement and sounds still remains. In l966 Al wrote, "Psychomotor Therapy, as it is now practiced, proceeds on a primitive non-verbal base, with words used only as expletives by the patients and as instructions by the therapists" (p. 88). And in l973 a statement concerning the purposes of the Psychomotor Institute described it as "devoted to the development and furtherance of non-verbal techniques in the broad field of human development -- psychotherapy, education and the arts." Second, as the reference to "expletives" suggests, considerably more emphasis was placed on the expression of anger during this early period than was the case later on. During my first experiences with structures I found it impressive that while enactors gave full vent to their anger, their sense of current reality remained wholly intact. If, for example, the "four foot rule" was accidentally overstepped and a slightly miscalculated "blow" happened to graze an accommodating "bad" figure ever so lightly, the rage would be interrupted by a crestfallen apology: "I'm so sorry!" as the structure enactor stepped back and then, again at a safe distance, resumed the furious symbolic attack as before. Occasionally group members would be directed to hold up one or more tumbling mats as a barrier and let the structure enactor beat against it in rage. It may have been on one such occasion that suddenly a loud banging was heard at the door. A group member went out and found a passerby from Charles Street, pale and frightened, who managed to ask if anyone needed help. Through the windows, he said, it sounded like someone being murdered. Assured that it was only a rehearsal for a play he left, dubiously shaking his head. Diane decided that a sign should be posted saying ACTING CLASS IN PROGRESS. Shortly after I had joined the Meetinghouse group the Pessos invited me to come to the Wednesday evening "experimental group" that met in their apartment on Beacon Street in Boston. Here now familiar exercises were done and new ones were tried out: one member of the group would be lifted and supported at shoulder height by the others; or one would lie on the floor looking up while the rest of the group stood in rectangle formation looking down at the recumbent one's face. The purpose was to see what feelings, associations, memories, or emotional behavior would be triggered by these exercises. In this group Diane and Al took turns with the rest of us in doing therapeutic work (structures) for themselves. Often we stayed afterwards, over coffee in the kitchen, trying to understand what seemed to be going on and how it could best be formulated and perhaps improved. During the meetings of this group the Pessos' attractive daughters -- three year old Tia, middle daughter Tasmin, and firstborn Tana -- would sometimes come in to claim their parents' attention. Although the effects of PS/P on the persons involved in it, including me, were certainly impressive, I still felt some doubts. A great deal of time had to be spent in mastering the three modalities of movement and carrying out other preliminary exercises. It seemed to me that no one other than the Pessos would be able to lead Psychomotor sessions -- especially structures -- the way they did. Most likely, I thought, only someone trained as a professional dancer would have keen enough awareness of body movements and the ways in which emotions affected the body to be able to lead this sort of therapeutic group. Probably I was better cut out for the more orthodox, verbal type of psychodynamic therapy in which I had been trained. Although I felt unqualified ever to be a PS/P therapist there was a great deal that appealed to me in the Pessos' approach. In a group the exercises served powerfully to strengthen group members' trust in one another and in ourselves. We were helped to realize that it was permissible, safe, and in fact rewarding to express both positive and negative feelings toward the figures that accommodating members of the group agreed to represent symbolically. And in doing structures, what a satisfaction it was to have a whole array of clearly defined transference figures, rather than just one whose identity seemed to shift so that there was no way of knowing whether one's feelings were toward that "real" person or were products of unwitting transference! Increasingly we could let ourselves get in touch with forgotten or unrecognized feelings by following the leads given by impulses we became aware of in our bodies, and could let these impulses move us into symbolic actions and interactions we would never have anticipated. Doing a structure was always a voyage of discovery; in the language of a slightly later era, it was a trip. Somehow it tapped another level of consciousness, something like a trance state, or a waking dream. But it simply expressed our own inner, often previously unconscious, feelings -- and there was always a positive outcome at the end. Al and Diane's insistence that both the preliminary training exercises and structures should always end positively was one of the things that very much impressed me about their method. In contrast to some of the other (verbal and nonverbal) group approaches to sensitivity training and the like that were being developed elsewhere, in PS/P groups no one was ever allowed to end up in a negative situation. If someone was ejected from the group, s/he was always brought back and made welcome again. If a person wanted everyone else to leave the room so that s/he could be alone, that person was persuaded to keep at least one positive accommodator in the room to call on in case of need. If someone wanted to end a structure by "dying", s/he was encouraged to look for an alternative means of expressing what felt like a wish for death. This might be done either by turning self-destructive impulses outward in an attack upon a negative target or by understanding the wish to die as a wish for symbolic rebirth -- for reunion with a "good mother" -- who could then be accommodatingly supplied. The positive ending of a structure was due not so much to the therapist's insistence that it should occur as to reliance on information furnished by the structure enactor's body. Al has commented, "We've never changed in that belief -- that the [pathogenic] experience was in the body and that the solution was also in the body, and that when we stayed close to that we always had an outcome. I was amazed that we always had a positive outcome, so long as we stayed with the body... Truth was in the body" (Note 2). Also impressive was PS/P's ingenious multiplication and polarization of transference targets. Ambivalence no longer blocked the expression of feeling because negative and positive emotions had different targets to interact with. One could experience purely negative feelings from -- and toward -- a "bad" figure and purely positive feelings toward -- and from -- a "good" figure. They were separate, and neither interfered with the other. Giving vent to negative feelings toward one symbolic person opened the way to expressing and experiencing surprisingly strong positive feelings toward -- and from -- another symbolic person. Getting the wished-for positive response sometimes reactivated negative feelings -- "Why couldn't my real mother (or father) have been like this!" -- and the enactor of the structure might again make angry gestures toward the "bad" figure, who would revive and accommodate to the renewed symbolic attack. After this the enactor returned with even stronger positive feeling to the "good" mother and/or father, who would respond in ways that seemed suitable. Although Al or Diane (as well as the structure enactor) sometimes suggested responses the "good" accommodators might make, the latter still, at this stage, remained free to respond as they saw fit. In deference to the view that this was an essentially non-verbal method, however, words were used only quite sparingly. A "bad" father could be chosen from among the men in the group; a "good" father could be another male; "bad" and "good" mothers were selected from the women, and if need be "good" and "bad" versions of a brother or sister or other significant figure could be chosen as well. A woman was never asked to accommodate in the role of a male figure, nor a man in a female figure's role. Generational identities were also made clearly explicit. "Good parents" in a structure related to each other in ways that they did not relate to their "child" (the structure enactor), but the "child" could be assured of some day having a contemporary partner of his/her own. Meanwhile the "good" parents provided for the satisfaction of all the basic needs of their "child". (How extraordinarily much simpler and easier this was, it seemed to me, than having one lone, ambivalently regarded therapist, with his/her single gender and generational identity, transiently take on and then give up one after another of these manifold transference roles!) Starting in the autumn of 1964, Al had been asked to try out Psychomotor techniques with a few patients at McLean Hospital, a psychiatric teaching hospital affiliated with Harvard Medical School and the Massachusetts General Hospital. Al subsequently brought Diane to assist him and later to run independent sessions with patients. The patients chosen for them were usually, predictably, the ones the staff found most difficult to deal with. Working with Al and Diane, many of these patients began to make noticeable improvements. The following year, in the spring of 1966, Jim Garland, then Director of the Activities Department at McLean, invited Al to conduct a series of training sessions for staff members, and Al asked me to help as an accommodator and also try to evaluate the sessions' effectiveness. This series marked the beginning of Al's efforts to train other people in the use of PS/P techniques, and we kept careful notes on what was done. Many members of this and later training group were on the staff of the Activities Department. One psychiatric resident started with the group but apologetically withdrew after a couple of sessions. His analyst, he said, had forbidden him to attend after learning that PS/P entailed actually, physically, touching people. A visitor from abroad who was a dance therapist had pleaded for a chance to join the group, and was admitted, but proved unwilling -- or unable -- to carry out the simplest action without irrelevantly adding a stylized, "artistic" flourish of her arms or hands. She left after a meeting or so, remarking that this wasn't any kind of dance therapy. (I then began to wonder if dance skills were as necessary a preparation for PS/P as I had thought.) The rest of the group continued through the ten sessions, and at the end tried to make arrangements to have more. For the most part the sessions were devoted to the exercises but there was time near the end for one or two members to have a structure turn. Around this time Al, sometimes joined by Diane, had started giving lectures that included demonstrations of certain PS/P techniques and exercises. Some of these were in psychiatric settings and others in universities, the latter usually at the invitation of psychology department members. Al also gave a series of presentations for the American Occupational Therapy Association throughout the U.S. In addition he had begun to travel in response to invitations from various professional groups and growth centers, including the Advanced Pastoral Counseling Association, which resulted in prominent mention of PS/P in Clyde Reid's book, Groups Alive, Church Alive (19--). Al gave a series of workshops for Oasis, a growth center in Chicago; subsequently Wilson Young, a psychologist, became the principal contact person for Chicago. Other cities in which he gave workshops included New York, Boston, Atlanta, Winston Salem, and Philadelphia. The Pessos moved to the suburbs of Boston, first to a big hillside house in Brookline and then to a beautiful woods-surrounded house on another hillside in Weston. Their house was designed and built to include rooms for two PS/P groups to meet simultaneously, led respectively by Al and Diane, each of whom had an active practice. During this mid-sixties period a few psychiatrists who had referred patients to PS/P groups had found this to be a valuable adjunct to the treatment they were conducting. Patients whose therapy had slowed to a standstill overcame whatever was blocking them and then continued to move ahead very rapidly in their treatment, according to these psychiatrists' reports. Now PS/P was also beginning to be seen as a valid treatment method in its own right, and as the treatment of choice for some clients. In addition, a number of people were attracted to PS/P as a means of furthering their emotional growth and achieving a higher degree of self-actualization. Some work with psychotic or other seriously impaired patients continued, but it was difficult to treat them in a group because they were not well enough attuned to each other to be able to accommodate adequately. A number of individual sessions generally had to precede the psychotic patient's introduction into a group, and since additional, relatively normal, accommodators had to be brought in, this kind of treatment was likely to be quite costly. Alternatively, a psychotic person might be included in a group of non-psychotic people; I recall Al once remarking that any group could handle one psychotic member. And certainly there were Psychomotor techniques available to handle whatever quasi-psychotic states of mind might occur from time to time in group members whose behavior for the most part appeared to be reasonably normal. The question of who, in diagnostic terms, benefits most from PS/P therapy (or emotional re-education) was often raised by people associated with the Pessos. Very likely -- and this may well be true of other forms of human service -- those who need it least are able to use it best. Yet people with a wide variety of problems and diagnoses have found their way to PS/P, apparently with benefit, and with no indication of harm. Accordingly, during the later 1960s referrals and self-referrals grew apace, and the Pessos prospered. Neither of them, however, devoted full time to PS/P. Besides his private practice, Al was still a full-time faculty member teaching dance at Emerson College, seeing patients at McLean Hospital, consulting at the Boston V.A. Hospital and pursuing his studies for Goddard College. Meanwhile Diane, besides having her practice at home and at McLean Hospital, was getting people and plans together for a "total living community" (TLC) on property some miles from Boston that they proposed to buy and develop according to what impressed me as an ideally convivial and sensible plan. Except for occasional social gatherings -- and the Weston house was a splendid place for parties -- I saw relatively little of the Pessos for a couple of years. In the spring of 1969 I was again drawn back; Al suggested that I participate in a group that was meeting with him at the Weston house in order to catch up with new developments in Psychomotor that had been taking place. Intermediate Version, 1969-76 I joined the group and was astounded. No more preliminary exercises! Even no more species stance, unless someone was at a loss about what to do in a structure. Then it could be useful as a way of discovering unnecessary tensions in the body that could point the way toward action or toward wished-for accommodation. There were other changes, too. Negative accommodation now utilized large foam-filled cushions on which kicks or blows were inflicted while a role-playing negative parent or other figure, now safely distant, winced and cried out with each impact. It was no longer necessary to worry about accidentally hitting the accommodator; also, hitting a yielding substance gave some people more satisfaction than striking the empty air four feet short of the target. A further major change had to do with sexuality, which had not been a topic dealt with directly in structures at the earlier stage. Now it was taken for granted that parents and children were likely to have sexual feelings toward each other, and these feelings were given clear symbolic expression in the structures that were carried out. Earlier the issue of sexuality had not come up in structures because the Pessos believed that what might seem sexual was actually a disguised need for nurturance. The latter was what they regarded as a young child's principal need. A particular kind of positive accommodation known as limiting was developed by Al. A precursor of limiting had occurred earlier, when accommodators playing "good" parents (often assisted by others in the group acting as extensions of the parents) lifted up tumbling mats as a barrier so that anger expression or furious onslaught of their "child" (the structure enactor) could take place safely. During this symbolic attack the "good" parents murmured sounds such as "Um hm" to indicate that they acknowledged the expression of anger by their child and were not letting themselves be harmed by it Return to Part One Go to Part Four Return to Book Excerpts | 
