'Muscle, blood, bone': how the body comes to matter in talk therapy

Two questions form the basis of this qualitative study: Do Cartesian notions of mind/body dualism influence the meanings therapists attribute to the body? How do therapists' ideas about the body influence the possibilities of body-oriented therapies? Research continues to show the value of body-oriented approaches to therapy, and combination therapies, for adult survivors of childhood sexual abuse. This study investigates notions of the body and the application of body-oriented techniques in talk therapy with clients with childhood sexual abuse history. Fifteen talk therapists, representing a range of disciplines including, psychotherapy, counselling, psychology and social work, participated in semi-structured interviews. Analysis of data clearly indicates that therapists consider the body and body-oriented techniques in their work, and that they are influenced by Cartesian notions of mind/body dualism. Therapists notice bodily behaviour and encourage their clients to be mindful of bodily responses. They advocate holistic mind-body practice while employing concepts that perpetuate the mind/body split. They are limited in their use of active body-oriented techniques and are careful to avoid physical contact with their clients. They want to include body-oriented techniques in their work but grapple with the idea that bodywork approaches are alternative and potentially dangerous. From their interviews three main themes were identified: safety, threat, and regulation. The first theme shows that therapists are enjoined to create safety for clients with childhood sexual abuse history. The second theme is linked to the concepts of the absent body and the threatening body. Phenomenological studies as proposed by Maurice Merleau-Ponty and Drew Leder are used to theorise the body as absent until disruption. Therapists employ a variety of body-oriented techniques at times of disruption—affective responses—to the otherwise absent body. Disruptions bring the body out of absence and contribute to the notion of the body as threat. In their performance of safety therapists are self-regulating according to explicit and implicit rules of safety in therapy practice. Michel Foucault’s work related to power and regulation is used to examine these practices. Karen Barad’s posthumanist theory of agential realism is used to theorise therapy as an apparatus, which in intra-active relationship with discourse, matter and meaning-making co-produces the phenomena of bodies. This relational theory collapses binary distinctions between object and subject, rendering Cartesian mind/body dualism redundant. The study finds that corporeality comes to matter in every aspect of talk therapy, and that how abuse, bodies, safety, and other phenomena are conceived, and intra-act with the material-discursive practices of talk therapy, co-produces the materialisation of bodies. It also argues that the particular iterative material-discursive practices and intra-actions of talk therapy result in various exclusions, namely the use of physically active body-oriented techniques. This study adds to the scholarship and literature in the field by identifying influencing factors in therapists’ considerations of the body and body-oriented practice in therapy. Its main contribution is the illumination of possibilities for conceiving therapy practice with clients with abuse history.