Finding the Line, Securing the Frame
This paper accompanied my speech to Rolfers and Rolf Movement Teachers, "Working With What You Can't Get Your Hands On," at their August 1984 conference. The title refers to a story about their founder:
"Word's going around Esalen that Ida Rolf thinks the body is all there is. Well, I want it known that I think there's more than the body, but the body is all you can get your hands on."
The Protean Body, Don Johnson, 1977
Rolfing® is a method of deep tissue manipulation developed by biochemist Ida Rolf in the 1940's to improve physical organization. Dr. Rolf believed that injuries — both physical and psychological — impair the body's relationship to gravity and that Rolfing restores it. She worked with "finding the line" (an imaginary plumb bob falling from the ear, through shoulder, hip and knee joints, to the ankle) as a guiding principle. Rolf Movement Teachers apply this metaphor to bodies in motion, enabling their clients to move more effectively.
Unlike psychotherapists, Rolfers and Rolf Movement Teachers touch their clients. Sometimes this distinctive difference has been used to claim, "Rolfing is not psychotherapy — therefore, the rules of psychotherapy do not apply." I believe differently: that practitioners who touch their clients particularly need ways to keep themselves and their clients appropriately oriented, their relationship professional.
Years ago I worked in a Lutheran agency that was outgrowing its space. Psychotherapists vied with one another for available therapy rooms, crowding the secretary's desk to check the schedule for who got which space when. If one therapist's session ran overtime, the next therapist and client waited in the hall. Therapists wished they had their own offices, of course, and felt awkward when it took several tries, client in tow, to land a room. The agency was expanding, and the staff wanted to serve as many people as they could. Therapists apologized when they had trouble finding rooms and then "did therapy."
Many of our clients came to the agency at their pastor's suggestion. They wanted answers; they avoided self-discovery. They seemed stolid, unimaginative, methodical — stereotypically "Lutheran."
That's what I thought then.
Now I think that we produced some of the behavior we subsequently diagnosed as problematic. We saw our clients as rigid. They may have been. Somebody needed to be. We were so changeable that we worked in one room one session and another the next.
Our diagnoses — "cautious," "rigid," "resistant to change" — presumed that we were neutral observers watching our clients operate in a neutral field. Instead we may have seen our clients' attempts to provide ballast while we rocked the boat. Only therapists who saw these clients
— week after week
— at regularly scheduled times
— in the same room
— at the same fee
— using the same therapy mode
could have discerned whether they were resistant to change. The behaviors we observed — which we thought described the clients themselves, and not our erratic treatment of them — may have been our clients' attempts to let us know that they needed more stability.
Ida Rolf talked about "finding the line," organizing the body. Psychoanalytic reformer Robert Langs talks about "securing the frame," organizing the therapy. The frame (short for "framework") consists of the prerequisites, the conditions, that allow effective therapy to occur.
The frame, according to Langs, is "a metaphor for the implicit and explicit ground rules of psychotherapy" (Langs, The Therapeutic Environment, p. 540).
"I'm using the term framework to alude to all of the ground rules of psychotherapy: the basic ground rules of set fees, hours, locale. ... There are also many implicit ground rules, such as not touching the patient, the understanding that communications occur only in the office and within the time limits of the session — things of that sort" (Langs. The Listening Process. p. 84).
Psychotherapy requires securing the frame. Rolfing and Rolf Movement work require finding the line. (Any thoughtful verbal or physical therapy has requirements of its own, analogous to psychotherapy's frame and Rolfing's line.) Frame and line are home-base, guiding principles. They are not sufficient, of course — practitioners need additional knowledge and skill — but they are essential, if only "to do no harm."
Treatment without attention to the frame carries the same liabilities as hands-on work without attention to the line: disorganization, regression, at worst, madness.
Langs believes that only a stable, secure frame permits effective treatment. With such a frame, clients can turn their attention to the work they came to do. Without that security, clients sense that something's wrong, but have scant access to what it is: "Are these walls soundproofed?" asks the psychotherapy client. ("Will you keep what I say confidential ?") "Your massage table creaks," comments the Rolfing client. ("I've heard stories about Rolfing that scare me.")
Clients may not know that they have the larger, parenthesized concerns or ask about them if they do. Clients may not realize that the psychotherapist's walls or the Rolfer's table worry them, but respond warily nonetheless.
Therapy and body work are outside clients' usual experience. They can't be expected to identify what's wrong or know what to do about it. They just sense that something interferes. This puts the burden on the professional — in Langs' work, on the psychotherapist; in this paper, on the Rolfer.
A worried Rolfing client gets on the creaky table and leaves her body. She tells apparently pointless stories about this shaky project and that childhood mishap.
The body worker who diagnoses the client as rambling or out of her body would be right, but in the same sense that we were right about the Lutherans' rigidity. Fix the table, start and end on time, stabilize fees, and wait for the client to return to her body. (Or not. The client who's intrinsically out of her body won't be healed merely by repairing the frame, but with a reliable frame the Rolfer can make a reliable assessment.) Then listen for stories about how they've fixed the water cooler at work, or how she's feeling optimistic about the coming election. This is Langs' discovery, that clients tell us about their framework problems over and over. They tell us until we hear them and make the necessary corrections. Then they tell us that, too. All in metaphor.
A colleague who made an important framework improvement was treated to a story about her client finding a marvelous building contractor, one who knew just what the house needed. Did really solid work. Hard to find a contractor that reliable.
Portland had a big storm while I was reading Langs the first time. Power lines snapped, schools closed. Many clients cancelled. One who came told me he was worried that the tree outside my office would blow down. The storm had in fact felled trees, but I was reading Langs, who said that such comments were clients' attempts to "rectify the frame." I did what Langs said to do: I formed a "silent hypothesis," an idea of what the client might be trying to say, then listened for validation of the hypothesis. I thought the client was telling me that something felt shaky to him, like it (the therapy itself?) might topple. I listened silently, hypothesis in mind. He then told me about his sister changing her vacation plans and a project at work not turning out as expected.
Halfway through the session, I commented, "Much of what you've told me is about instability, unpredictability ..." He interrupted to say, "I just remembered: last week we didn't meet at our regular time and I didn't like it. I felt 'off' the whole week."
Something outside his awareness kept knocking, trying to come in. First the tree, then his sister's plans, then his own work. Closer and closer.
When I named the common thread, he became aware of his complaint and expressed it. For the rest of the session, he spoke clearly, purposefully. He left looking better organized bodily than when he came in.
Imagine how we'd have floundered if I'd gone after his fear of falling trees or his feelings about his sister. Imagine assessing his wary shoulders as structural and working on them physically.
When the frame is good enough, clients settle into their bodies, like anxious infants who relax once they're in the right arms. They become as available as it's possible for them to be. Structural, functional, and psychological limitations remain, of course, but clients function maximally within them. Literally, bodywork clients in a secure frame put their best foot forward.
Seeing this, I speculate that Rolfing clients who can't "hold work" are having trouble with the frame. Something's going on that feels toxic to them. They're in a bind, trying to keep the event ("He's late. Again") or its meaning ("He doesn't think I matter") out, while letting the work in. With a better frame they would either become more receptive or clearer about why they weren't ("This process is going way too fast for me," for example). Both help treatment.
Picture a client whose alcoholic father beat him. Dad gets home late. All the kids are in bed. They hear him and hold their breath. Is he drunk again? What will he do? Thirty years later this man is getting Rolfed. The Rolfer is bigger than he is. Sometimes the Rolfer's on time, sometimes he's late. Fees have changed. The client is supposed to strip to his underwear and lie on the table.
Stabilizing time and money can't change this client's history, but stability — a secure frame — can help him distinguish between the past and the present. Thus oriented, he's more likely to allow and hold work.
Before he can be receptive, the client must be oriented. He must be able to separate the "now" from the "then": the less the Rolfer's behavior echoes that of the man's abusive father, the better the client's opportunity to orient himself. Framework helps clients orient.
When the therapist/body worker becomes clearer, as represented by reliable framework, the client becomes clearer too: clearer about his trouble separating the past from the present, his confusion, personal disorganization, dysfunction. Paradoxically, the client's confusion is much easier to work with than his attempts to keep himself together, to protect himself from instability as represented by a messy framework. Rolfers benefit, too. Less comes at them that belongs to people in their clients' past. (This may explain why some six-session days are a breeze and others exhausting: well oriented clients are easier to work with than people who are struggling for their balance.)
I felt a 40% drop in effort when I moved from working at home to working in a downtown office and paying close attention to framework. My new office said for me things I'd previous1y had to say for myself: I am serious, I am professional; this is confidential; I'll know what to do. Just as a body in harmony with gravity moves more efficiently, a therapy protected by secure framework becomes quieter, clearer, more to the point.
An adequate framework orients clients. It also reassures them. Langs speculates that clients see our inability to master punctuality, fee setting, scheduling, et cetera as evidence that we're incompetent or disturbed ourselves. This speculation makes three kinds of sense to me:
1. Clients are not trained body workers or psychotherapists, so they can't judge our work using professional criteria. Nor can they use the ordinary standard that "if it hurts, it's bad." What's left is judging us using areas of management they know about: time, money, housing.
2 My own disturbances do, in fact, show up in ways I violate framework: my rebellion ("I didn't become self-employed to have to hurry back from lunch by one o'clock!") my guilt ("I really haven't gotten to what's going on with her, I'll give her extra time"); my discomfort with being disliked ("If I don't go along with him, he'll get angry").
3 I'm most likely to make framework mistakes before I go on vacation, while-I'm getting sick, and after a potent Rolfing session. In transition myself, I "spill over" onto my clients. I don't hold the frame.
Langs posits that clients experience a disturbed frame as a disturbed therapist. It then follows, he says, that they experience a reliable frame as a reliable therapist. Clients whose therapists have trouble with framework try to "fix" their therapists by focusing on framework violations, hoping the therapist will repair them. Then the therapist will be competent again, and the client can hope for help.
This supposition, that clients offer rudimentary supervision, doesn't need to be taken on faith. Looking with Langsian eyes, listening with Langsian ears, provides evidence. The following illustrations come from my practice:
I go 10 minutes overtime The client is 10 minutes late for her next session. She gives me back the time I gave her. I increase the per hour charge for my therapy group; they cut back on how long the group meets, thus restoring the original fee.
I see a couple for two sessions in my office then once in another office because mine is full of paint fumes. During their fourth session. back in my office, they describe the third session as diffuse, disorganized. hard to hold onto.
I give advice; the client forgets his next session. I behave "not like a therapist." he behaves "not like a client."
"Indirect Communication" (Langs)
Transactions involving time, money, locale and behavior occur each session and of course affect the client. Clients are also affected by variables outside their sessions.
In supervision, a trainee tries to figure out what's going on with a client who's missed the last three sessions. I ask what her client discussed the last time she came in. The client talked about two people at work, how she thought they were plotting against her. Recalling this, the trainee said, "Oh, I've begun working with the woman's daughter She must feel that we're uniting against her."
Privacy/exclusivity often is an issue for clients, one they have trouble addressing directly.
This last example speaks to an encouraging phenomenon: how diligently clients try to tell us what they need before they give up and go away (literally, or by being in the room but not present). If the therapist hears what she's being told and repairs the frame, the client doesn't have to leave. When the frame is repaired, then so-called difficult clients — clients who have particular difficulty in the absence of secure framework — can stay in treatment. They finally get what they came to therapy for, many years and many therapists ago: a place where they can do their work.
I finally learn to "just listen" to one client (not intrude on her with my thoughts). She' then tells me about taking a graduate school class taught by a taciturn psychiatrist and how his silence enabled her to risk more, put more of herself into the class.
Fortunately, clients tell us when we get it right, as well as when we don't.
Securing the frame and listening for indirect communication about framework issues is crucial for body workers, given the unique difficulties (for both participants) that accompany touching one's clients.
To appreciate these difficulties, imagine yourself lying down. Someone is touching you. Is the touch kind or cruel? Are you their child? Their lover? Are they the doctor and you their patient? Do they have your permission to touch you the ways they do? How do you feel? What else is going on in the relationship?
Reverse the experiment. Who besides your clients do you touch? Your kids, your friends, your lover, your once feared but now feeble father? What do your hands carry when you touch your clients?
All this and more is present when people touch. Most psychotherapists don't touch their clients, believing it's their job to understand clients' needs ("You feel alone and wish you had more friends"), not to gratify them (with, for example, a hug that implies "I'm your friend"). Touch generally interferes with the therapist's task, which is to understand what's going on.
For the professional who touches clients, the situation is more volatile. The potential for disorienting clients--and becoming disoriented oneself--is greater.
Unfortunately, few practitioners are trained in the importance of such "details" as starting and stopping on time, meeting regularly, keeping fees constant, offering a work space free of personal material, preserving confidentiality, and the like. Given the absence of such training and the presence of the emotions that touch evokes, what's impressive is that so many practitioners and clients do so well. Confusion is endured. Work gets done.
Were Rolfers to provide secure framework, however, there'd be less confusion and more work. Plus, a secure frame would make clients' stories — as well as their bodies — available to guide the work.
For instance, a usually punctual client arrives late and flustered, with a story about being unable to find a parking place. His lateness is not a response to the frame: sessions have begun and ended on time, his calls returned promptly; he has a regularly scheduled appointment. Getting on the table, he begins another story. It's disjointed, hard to follow. The Rolfer recalls that at the end of the previous session she'd wondered whether he could handle a bit more. Yes, she thought then. No, his stories and his body tell her today. She decides to devote most of the session to integrative work. She'll track whether he's on time for his next session and what stories he tells then.
Clients tell us what they require, but not in everyday language. They speak in metaphor, in the checkbooks they forget and the work they can't hold. Rolfing clients may be particularly dependent on such "language" because they've never before experienced anything of Rolfing's magnitude. I'm very aware, for example, of having had to learn to talk to my Rolfers: in the first place, I didn't know how to distinguish between emotion and sensation, and secondly, growing up in a rural Republican farming community hadn't taught me the words for rapid change.
My psychotherapy clients who are being Rolfed walk in with bright eyes and changed bodies and don't mention having had a session. What they do mention, often in metaphor, are their Rolfing framework difficulties. When a client casually says, "I keep forgetting to call and reschedule that session he cancelled," I may hear aggression ("I'll 'forget' my Rolfer the way he 'forgot' me") or perhaps futility ("There's no reason to call him, to try to reconnect it won't matter"). There's no line-for-line translation, only what comes before and after makes meaning of such seemingly innocuous statements. (Of course, if I'd cancelled a psychotherapy session, I'd assume the Rolfer was a stand-in and that the comment applied to me.' When a client asks me, "Do you think the answering service told her I called?" I'm alerted to the possibility that the client doesn't think the Rolfer is listening to her. I can then work with my client to sharpen what she has to say and so increase her chance of being heard. Were I the Rolfer and a client asked me whether her message got to me, I'd answer her factually, then consider the metaphor. I'd ask myself, "What happened during the last session to make her question my capacity to listen to her?"
Other clients tell me about their Rolfing experience directly; the metaphor lies in how they tell it. They simply report, without any apparent sense that I can help them or would want to. Their strategy for getting through the session — "I'm alone, and I have to handle this by myself" — pervades their talk about it. From a woman, what she says to herself during a session: "He's a man and he's hurting me, but this isn't abuse." From a man, "This isn't a wrestling match. It's okay that he has me pinned." These are people reminding themselves of the context, people trying to stay in the present despite pulls to the past, people trying to make sense of their experience.
These are also people so profoundly alone that it doesn't even occur to them that it could be otherwise. A more secure frame might diminish the past's claim on them and enable them to see their Rolfer as someone who can be there with them. Then they wouldn't have to be so alone.
I remember a Movement session following a loss that gutted me. It hurt to breathe. Nothing looked familiar. Driving to the session, my hands on the steering wheel didn't look like my hands. The road was oddly flat. Light hurt my eyes. Once in the session, I talked and talked. My Rolf Movement Teacher waited, still and silent. Desperate, I kept talking. Eventually I heard myself and pause: "As soon as you touch me," I told her, eyes stinging, "I'm going to cry — and I don't want to." I can still see the tender look on her face as she met my eyes and nodded. Silently.
Clients tell me about attempting to engage their Rolfers directly, by asking questions. Sometimes they want interaction, sometimes they want information. Often they are frustrated. I think there are four causes for this frustration:
1. Clients ask questions but lack the kinesthetic awareness to understand the answers/Rolfers answer clients' questions using words that have meaning for them but not for the client.
2. Clients ask questions instead of saying "no."
3 Clients ask "ballpark" questions in place of the questions they can't form, then feel dissatisfied with the answers.
4 Clients ask questions that go unheard and unanswered.
1. Clients ask questions but lack the kinesthetic awareness to understand the answers/Rolfers answer clients' questions using words that have meaning for them but not for the client. For example, Mary, a woman with a firmly locked jaw, balks when her Rolf Movement Teacher suggests she "soften her vision." What do eyes, she demands, have to do with jaws?
She wants an answer. "Feel how your jaw relaxes when you let your eyes rest back into your skull" says her teacher. That doesn't tell Mary anything; she can't feel a connection between her eyes and her jaw.
Frustrated, Mary believes the practitioner has ignored her question. She tells herself it doesn't matter. And locks her jaw.
2. Clients ask questions, instead of saying "no," which may be what Mary's doing when she asks what jaws have to do with eyes. Obviously, such "instead-of" questions can't be answered satisfactorily. It is Langs' discovery that clients typically stall, typically ask questions that aren't really questions, when the framework is unstable. Mary can't say, "I won't trust my jaw to you: you rescheduled last week's appointment," because she doesn't know she's made that equation.
The practitioner who studies framework assumes such equations. When she's getting unvoiced "no's" or unanswerable questions from clients, she identifies what she's done to disrupt the frame, then changes her behavior, and waits for confirmation. (Or disconfirmation: Repairing the frame may not affect Mary's behavior. The practitioner could then trust that both the behavior and the physical patterns she's seeing accurately represent Mary.) By providing a sturdier frame, she's likely to get a sturdier "no" the next time she suggests that Mary soften her vision: "I don't want to. I get nauseous just thinking about it." Mary may even discover she has a deeper objection: "I feel like you're criticizing me when you tell me to change my eyes."
3. Clients ask "ballpark" questions in place of the questions they can't form, then feel dissatisfied with the Rolfer's answers. John likes and doesn't like being touched. Touch evokes both the arms that once held him and his "getting too big for this sort of thing." John is unaware of these memories but he knows he feels wary about Rolfing. He repeatedly asks for his Rolfer's credentials, for "facts" about Rolfing. He wants to know this, he wants to know that (Repetition is a clue that the questions, as well as the answers, are unsatisfying. A well-formed, pertinent question brings relief, even if — like Job's, "Why me, God?" — it can't be answered.)
Unknown to him, the "information" John wants is reassurance that he won't be deserted again. That's what he's trying to get at with his questions about competence.
The Rolfer cannot reassure John adequately in words, particularly words about his credentials. He can attend to framework, however: scheduling John's sessions regularly ("Tuesdays at four," even "The first Tuesday of the month, at four"), starting and ending on time, holding fees constant, providing space where they won't be interrupted, and so on. He can be consistent and therefore reliable. With the reassurance provided by a stable frame, John may be able to stay in the present and out of his historical dilemmas long enough to become someone whose Rolfed body no longer replays those dilemmas.
4. Clients ask questions; their questions go unheard and therefore unanswered. Some strongly kinesthetic Rolfers/Rolf Movement Teachers simply don't get it that others orient themselves by asking questions and getting answers. Touch is what orients them — their way of getting and giving information. Since they touch their clients, it seems to them that their clients have the information they need. Clients' questions are mere chatter, not to be taken seriously. Proof lies in examples 2, and 3: the kinesthetically aware practitioner senses that many questions "stand in" for something else. He or she then fills in that the needed something else is touch, or the line, or being over your feet, or some such.
About half my psychotherapy clients also work with a Rolfer. (There are six in town.) periodically they tell me the Rolfer has hurt their feelings. Specifics vary, but every complaint I've ever heard boils down to one: they feel unacknowledged. Sometimes this is the result of a framework muddle (a woman hurries to get to her session on time; the Rolfer is half an hour late). Sometimes when they feel unacknowledged, their feelings are transference-based (a man wants the attention from his Rolfer that he needed from his father; he feels slighted when he doesn't get it). Often when they feel unacknowledged something hurtful has indeed occurred. They've been ignored ("he didn't even answer me") or diminished ("she suggested I read a self-help book"). They weren't responded to in ways they found relevant — with information, compassion, whatever; they then felt unacknowledged. (Acknowledgement implies relevance: only that which is personally meaningful allows anyone to feel acknowledged.)
Listening to my clients, I think of Alice Miller's concept that we pass on the early psychological injuries we can't master (The Drama of the Gifted Child). By implication, Rolfers who don't acknowledge their clients weren't acknowledged themselves (and haven't recovered from the injury, hence their passing it on). The Rolfers who persistently miss that their clients need "X" from them — words, for example — didn't have crucial early needs of their own responded to, acknowledged
Everybody had to go to school and schools damage kinesthetic kids, the ones who'll choose hands-on work when they grow up. Schools don't see that some kids learn by doing, using their bodies to determine what's real. Schools don't acknowledge kinesthetic learners. They don't fit. They're not valued. Schools ignore these lively children, diminish them, want them to be different — the same damaging messages that bodyworkers sometimes send their clients. The kinesthetic child whose needs were ignored becomes a practitioner who ignores clients' needs. "He didn't even answer me." "She told me to read a self-help book." The injury is repeated. There are two protections against passing one's injuries on. The first is resolving them. The second is developing a strong sense of orientation: "This is what's appropriate for me to do while I'm working; this is not." Framework helps the professional orient both by requiring certain behaviors and excluding others and by strengthening the practitioner's sense of being "at work," "on duty."
The Rolfer who doesn't respond to his client's question is disoriented: no one who's oriented purposely makes his work harder. He is caught in a replay, repeating the indifference that once greeted his own questions. This is not to say that a Rolfer is obliged to talk while he works, only that — if he doesn't — he needs to interpret his silence to his clients: "Sometimes when I'm concentrating I don't hear what's said to me." Oriented himself, he can orient his client. The Rolfer who tells her client to read a book is disoriented too: she has forgotten what she's there to do. Her personal feelings toward her client (compassion? impatience?) spillover; she's unable simply to acknowledge her client's experience: "Life feels hard to you right now."
Disorientation can't be eliminated, particularly where touch is involved, but attention to framework can reduce it. Both client and practitioner then stand a better chance of knowing who they are in relation to one another and behaving accordingly.
Attention to the frame also sensitizes the practitioner. Rolfers who are habitually "off-schedule" are less likely to notice that a specific transaction is "off." Rolfers who work within appropriate boundaries can catch their inappropriate impulses
Catch, not eliminate. Such feelings, such impulses, are always present. What's useful is curiosity about them: "Why am I wanting to tell this client about this movie?"
Scenario #1: It's her life's story, that's why. Maybe she'd realize it if she saw it in a movie, how she always lives in the future. Hmmm. How could I help her realize it right here in the session? Maybe if I asked her to focus her attention where my hand is and tell me what she notices
Scenario #2: I want to tell her about the movie because last session she told me about a movie. Maybe if we keep talking movies, she'll discover that there are two of us in the room — out of the room, actually. She tells me about sitting in a darkened movie theatre and seeing one movie, I tell her about sitting in a darkened movie theatre seeing another. That may be as close as she can come, for now, to being here with me. I'll talk movies with her and keep working to get the panic out of her chest.
Scenario #3: Damned if I know why I want to tell her about the movie, but I sure do. In fact, I want to tell her about the movie and the book I'm reading and what I had for dinner last night. Why so much me? Why such a powerful urge to talk?
Questions that bring no understanding need to be asked out loud, in peer or formal supervision. (Ideally, both: there are some things you'll learn only from colleagues, others you'll learn only from a designated supervisor.) When you ask yourself questions and corne up with plausible answers, that's supervision too.
Supervision is a process for moving from impulse to understanding. It works best when you maintain a frame that keeps you from acting on your impulses without awareness. They then become available for examination.
For example, on the way back from lunch you remember an errand you've been meaning to do. If you do it, you'll be late. You feel like doing it (the impulse). This is where framework is crucial:
If you decide to show up on time (framework) and to trust your impulse's relevance (supervision), you then may recognize ways your after-lunch client subtly courts neglect. With this understanding you see his bowed shoulders in a new light.
You've also increased the possibility that you can straighten them by declining his "invitation" to disregard him, to behave in ways that make his stooped shoulders appropriate. (A client's persisting in stuck places — ones the Rolfer can't get to move — may be physically manifested states of mind. Hands-on work won't be fully effective as long as the Rolfer's behavior reinforces the client's world view, e.g. "I'm someone people don't take seriously.")
Supervising therapists, I notice that they get interested in framework when they're ready to do deeper work. Since clients stay at a more superficial level until they feel secure (well-held by the frame, in competent hands), practitioners can protect themselves from issues they're not ready to address by ignoring framework. Such "protection" is understandable, although I think mastering framework offers more reliable protection. Flinching is natural. Our clients' lives and bodies are hard to look at. So is our own work: Serious psychotherapists and serious Rolfers "cause" their clients pain (in both the literal sense and in the sense that when Mary's jaw unlocks, her despair will surface). Psychotherapists and Rolfers impair their clients' present functioning in hopes of improved future functioning.
These are not easy things to look at. Framework and supervision make the looking bearable and provide ways to address both the practitioner's and the client's dismay. With such support, work gets deeper and clearer. Clients begin to address essential issues:
One of my older clients has begun to use the phrase "in the time I have left". Another just realized she pushes for certainty because there is none. "You mean lead with my heart?" I gasped, incredulous, when I understood how my Movement Teacher wanted me to walk.
Often practitioners who ignore framework and choose confusion are replicating the circumstances of their training. When they were students, classes didn't start when scheduled, interactions appropriate to the classroom occurred over lunch, trainers "did therapy" with trainees.
When teachers blur framework and duck hard questions, it is likely that practitioners will do the same.
Since body work is necessarily intrusive, practitioners need to keep any avoidable intrusions at a minimum: personal opinions, changes in time and setting, outside contact. Otherwise, attention clients could devote to the work gets spent sorting non-essentials.
A secure frame helps both the practitioner and the client focus their energies on the work at hand. It makes assessment and supervision possible. It reduces the transference-based confusion induced by touch, while increasing clients' confidence in their practitioners. Securing the frame allows the sensitively attuned Rolfer to work "with what you can't get your hands on."
These ground rules come from the Freudian tradition, supported by one hundred years of trial and error. Many psychotherapists have experimented outside these rules. What is notable is how many, then, have returned to them.
For a variety of motives, including disbelief that they're particularly important, I have violated each one. These violations I now categorize as "mistakes I made that others had to pay for." My current standard for practice is that I either uphold these framework basics or have a reason, based on conscious, examined perception of my own or the client's needs, to alter them.
1. Sessions begin and end on time.
2. Each session is at the same time, at regular intervals.
3. Nothing interrupts a session.
4. Fees are set before work begins and remain constant.
5. Clients are unaware of one another. (Mary doesn't see Hank leave his session.)
6. Therapists have no social contact with clients, including former clients.
7. Nothing said inside the session is continued outside of it with the client (boundaries) or repeated to anyone else (confidentiality).
8. Therapists don't ask their clients to attend to them ("Boy, did I have a hard time parkingl").
9. Therapist's words and acts relate to the client; the purpose of each intervention could be identified.
Casement, Patrick. On Learning from the Patient. New York: Tavistock Publications, 1985. Casement, a British psychotherapist, offers example after example of trying to understand what his patients are telling him--in indirect ways--about their work together.
Kopp, Sheldon, Back to One. Palo Alto, CA: Science and Behavior Books, Inc., 1977. Kopp presents framework as a meditation. A good book for identifying all the choices — answering service or machine, billing or payment per session — that make up a practice
Langs, Robert, M.D. The Listening Process. New York: Jason Aronson, 1978. Langs' books are transcripts of his interactions with trainees, usually psychiatry residents, in group supervision.
Langs~ Robert, M.D. The Therapeutic Environment. New York: Jason Aronson, 1979
Miller, Alice. The Drama of the Gifted Child. Trans. Ruth Ward. New York: Basic Books, 1981. This important book describes how children respond to not being seen or valued for who they are.
Wilhelm, Kate. Margaret and I. putnam, 1980. A novel written from the point of view of "I",. Margaret's unconscious. Much of the plot tension centers on Margaret becoming aware of information she habitually disregards.