Body-mind integration in the helping professions: Implications on identity, status and boundaries of the professions and professionals.

In the past few decades paradigmatic and theoretical changes have occurred in various professions, including the fields of social work and clinical psychology. As a result, diverse opportunities for professional change and development opened up for social workers and clinical psychologists. However, these changes did not necessarily conform with the traditions in their professions. One such change in the practice of both social work and clinical psychology consists in the increased integration of body-mind therapeutic methods into psychotherapy. Even though these methods were taken up by professionals who treat a range of conditions and specific populations in their practice, their influence on the disciplines of clinical psychology and social work as well as on the practitioners themselves has yet to be researched.  The purpose of the current study is to fill that void.

This study is based on two theoretical approaches. The first is rooted in sociological perspectives that deal with boundaries between professions.  The second consists in psychological approaches on how professional identities are structured.  The main research questions this project explores are:  firstly, what motivates the integration of body-mind therapeutic methods in verbal psychotherapy; and secondly, what are the perceived outcomes of this integration on professionals and the verbal therapy professions.

This study explores the phenomenon of integrating the body in the main verbal therapy professions, i.e. social work and clinical psychology.  These two professions were selected for this project as they both rely on verbal psychotherapy on the one hand, but also differ from one another in regards to professional boundaries, status and identity, on the other.  A clear description of these differences can contribute to a better understanding of the integration phenomenon and its outcomes.

The research questions are explored from two perspectives.  One is at the micro level, that is: through the eyes of professionals - social workers and clinical psychologists - who integrate the body into their work.  The second is from the perspective of professional leadership and policy makers at the macro level in academia, training programs and in the practice of these professions.

Research on the integration of body-mind methods in verbal therapy looking at professionals’ perspectives has never been carried out in Israel, according to a review of the literature on the topic in the main academic journals, nowhere else in the world.  Given the lack of preexisting research, qualitative research methods were favored to facilitate an in-depth exploration of this new and complex phenomenon.  The data collection was based on 44 semi-structured, in-depth interviews with social workers and clinical psychologists from two research groups: 28 integrative therapists and 16 profession leaders.  The method used for data analysis is the “Grounded Theory”.  It applies content analysis and defines thematic categories while preserving the standard criteria selected for research reliability, and ensures that research and professional ethical guidelines are respected.

The research findings draw a complex picture that reveals gaps, tensions and clashes at various levels: between practice and policy, groups and professional communities, the individual and the group, and among various therapeutic paradigms, as well as the individual’s own multiple identities.

The findings inform both to the macro level of the phenomenon and the micro level of the individuals involved.  At the macro level, the research reveals strong objections by policy makers in the verbal therapy professions towards introducing the body into their frameworks.  Their opposition to the body is rooted both in these professional traditions’ exclusion of the body from their profession, and in political ideologies linked to status, control and power.  It appears that the various objections stem from two main sources: opposition to change and fear of the body.

The research findings reveal that despite strong objection from leaders within these professions, there exists a process of change and body-mind work is introduced into the practice of the verbal therapy professions by practitioners in the field. This shows that professional boundaries are expanding to include, for the very first time, theory and practice of body-mind therapy. Therefore we are witnessing a process of shifting boundaries in these professions despite the views of leaders in these fields.

This research further indicates that the discourse on the body in therapy encompasses the notion of place, both in regards to the body's place in the therapy room, but also concerning the body's place in the verbal therapy professions. Policy makers try to push the body out of the therapy room and out of their professions.  By contrast, the integrative therapists seek to expand the boundaries of the profession and bring the body into their professional work.  Thus a broad spectrum of justifications found for positioning the phenomenon in the professional space. It was therefore proposed that the body’s place moves between being excluded to being allowed, or in other words, between being excluded from professional institutions to being permitted in professional settings.

At the micro level, this research elucidates the identity of integrative therapists.  This project reveals a secondary process of professional identity consolidation during which the therapist shifts from being a "common" professional to being an "uncommon" professional while coping with difficulties and the need for finding solutions.  In this process, the therapist moves from the experience of clashing world views, to one of integration.  Towards this end, the process finds these therapists consolidating into unique identities of their own.

It was further revealed that there are two main prototypes of integrative therapists: 'clinical' and 'body-mind' therapists.  They are differentiated by their professional identities, their affiliation to their primary profession and their style of work with the body in the room. The majority of the integrative therapists in this research are of the clinical type, having stayed close to their primary profession and continuing to identify with it.  Their working style with the body in the room is restrained: that is, moderate integration style, which usually involves sitting in a chair, paying attention to bodily sensations and discussing them.  This style assists the clinical integrative therapists in bridging different traditions and adapting their work with the body in order to remain loyal to the profession.  For this purpose they use strategies as split, dilution, translation and mediation, which reduce the place of the body in their work and make integration possible in the framework of the profession’s boundaries.

'Body-mind' integrative therapists are the second type.  They have fully adopted body-mind work in theory, terminology, practice and room setting. Their work includes movement, touch, vocal expression, music and various accessories.  It appeared that their association with their professions as social workers and psychologists has been a substantial challenge, and distancing released them from a stringent professional framework.  They enjoy far greater autonomy and protection from criticism. They have embraced a strategy of exit from their original professional territory.

A central theme surfacing in the research is body visibility, both in the therapy room and in the therapist’s identity.  It was found that there is a significant connection between the behavioral level (the visibility of body-mind in the room) and the identity level (visibility of the therapist’s body-mind identity) in both types of integrative therapists.  This study also concludes that visibility alters over time, space and context.  This allows for optimal positioning of the integrative therapist within the professional and social hierarchies.  Considering this position, it is possible to learn of the diverse and flexible applications of visibility as a strategic tool in the struggle for power and recognition.

A final layer present in this research is the similarity and dissimilarity between clinical psychology and social work relative to the phenomenon of body-mind integration.  The main differences surfacing in the research relate to the general population of psychologists and social workers, as perceived by the research participants. The findings indicate that there is a conservative tendency amongst psychologists as a group compared to openness among social workers, particularly with regard to deviation from the professional norms and attitudes towards the body in therapy.  However, among research participants, considerable similarity was found between integrative psychologists and integrative social workers. This possibly can be explained by the blurring of professional differences among professionals due to their shared involvement in psychotherapy as the practice of both professions and by their specialization in the body-mind field.

Mapping the phenomenon of integrating the body in the main verbal therapy professions is a seminal contribution to a field that has hardly been explored so far. We are witnessing a complex and layered picture of identities, depicting the reciprocity between the individual and the socio-professional field.  On the one hand, we can see the impact of the social field on shaping the individual’s identities and the hierarchical saliency among them. While on the other hand, we can perceive the ability of the individual and group of individuals to influence the social systems in which they operate. Both the integrative therapists and the verbal therapy professions in general face two sets of coexisting dynamics:  the nexus of strength, impact and threat, along with the tensions between weakness and subordination, force and gaze.

This dialectic picture reveals the complexity of the relationship between individuals and society, between minority and majority cultures, and between therapists and their profession. 

This research concludes with emphasizing the need for defining a clear and cohesive identity for the professionals and for the professions, as one. Identity with clear yet flexible boundaries, that fosters the development and actualization of the professional practice for the benefit of clients, professionals and society as a whole.