Constellations, Psychotherapy and the Body
Working with, and understanding the body has been my main preoccupation throughout my career. During my working life, I have specialised in working with people who have cancer, migraines, persistent headaches, neuro-muscular-skeletal issues, and all sorts of chronic illnesses. Much of this work has been in the context of multi-disciplinary teams, such as the Bristol Cancer Help Centre (now Penny Brohn Cancer Care); The Headache Clinic in Yeovil; and NHS hospitals. I am familiar with the discipline of helping clients psychotherapeutically, within the context of what is happening physiologically.
I have been preoccupied by questions of why people manifest one symptom as opposed to another, at this particular time and not another, and what the body is trying to express by the symptoms it produces. I have developed skills to listen to the quiet voice of the symptom, and to amplify that, so that it can be heard amidst the myriad external voices of Dr Google, the NHS guidelines, exercise gurus, diet advisors, and photographs of the ‘ideal’. All of these have louder voices than the ‘quiet voice’ inside us.
Along the way I have had amazing teachers – in particular Lily Cornford (a healer) Barbara Somers and Joan Swallow (psychotherapists) and above all, my own body. The latter has made amazing symptoms, and given me deeper understanding of illness, and dis-ease.
The Creativity of Symptoms
A symptom can be read as a message from the inner world to the outer world that all is not well in the balance of psyche (the totality of conscious and unconscious energy of the person) and soma (the body). Making a symptom is an act of extraordinary creativity by the body. We are more familiar with this than we might realise, and it is there in our language ‘we are pissed off’, ‘something sticks in our throat’, we ‘cant digest this situation’ and so on. A symptom follows the same pathway as a dream – from our unconscious to our conscious – but of course the symptom is physical – it is a message from the soul, made flesh. Louise Hay has written about this extensively, but inevitably, she is generalising, and in fact each symptom will have its own unique personal story, as unique to the individual as their fingerprint. Like a dream, symptoms have their own internal logic, subtlety and symbolism, and must be attended to with ‘an ear to the sacred’.
The Aetiology of Disease
How did an illness evolve? And why this illness and not that? If we have cancer, why did it develop in one place, rather than another? Does the body have any wisdom about these matters? And might this be a useful insight in restoring a good balance between body, mind and emotions, and soul. What is the story of the disease, from the perspective of the client? Many people will have an inner knowing of the rightness of their story, and this story will be unique to them. It is not the same story for two cases of breast cancer; and two people with breast cancer will have two unique stories. A symptom therefore will have two stories – the outward, western medicalised story ‘This patient presented with … on …. and the findings were… and the treatment plan is …” but also a second, inner story, more poetic, more personal, often not articulated. For example a man who I worked with had an unusual lung cancer, although not a smoker. He had spent many years working in the emergency services, and his radio was on his jacket, exactly where the cancer had appeared. We talked about how difficult his life was in the services, and how he got a ‘jump’, a small shock, every time his radio sounded. Now retired, he didn’t look back on his working life with any joy. Every time the radio sounded he felt anxious and inadequate, could he live up to the expectations of his role? In his poetic mind, the cancer and the many small shocks were connected, although medically there was no evidence for this connection. Our work together concerned processing the traumas of his working life, and making his retired life meaningful and fulfilling; so that his battered self esteem was up to the new challenges of retirement. Our work together involved freeing up the life force that was previously tied up in the shocks and therefore not available to him, so that it became available to him to live in the present, and to aid his recovery.
Western medicine specialises, so that different consultants are needed for different parts of the body. This leads to excellence in terms of the knowledge and practice of the specialist, but makes it very hard to see the whole picture. Sometimes the more poetic approach of ‘what ails thee?’ will bring the issues into coherence and focus. In the latter case, the inner world and the outer world are seen as one, and the relationship can be rebuilt between psyche and soma. The whole is then greater than the sum of its parts.
One factor in the development of illness is the gap between emotions and thinking on the one hand, and soul on the other. If the gap becomes insupportable, symptoms arise. So the development of illness is in part a factor of timing – what is going on in life, what are the pressures of life at this time? A Chronic Illness is named after Chronos – God of Time, or Old Father Time (for example, ‘chronology’ ‘anachronism’, chronicle). Therefore a chronic illness can be seen as a snapshot of time.
A mythological lens for interpreting symptoms is one helpful starting point to understand the story of the symptom. The language is inevitably metaphorical and symbolic, not logical. Chronos is the earliest of the Greek Gods, he is the start of Time. (It is important here not to confuse Chronos with Cronos, the Titan, father of Zeus). His sister/consort is Ananke (force, constraint, necessity; or Destiny). Their children are Aether and Chaos. Aether represents the rarefied air that only the Gods can breathe, and Chaos represents wind, perhaps the wind of change, air that humans can breathe, and from these two come the Cosmos.
With Chronos’s influence, there is the factor of time, and therefore aging and mortality. He controls the right order of things, so that everything happens in a timely fashion. He is in control of due process, and if these factors are out of kilter, a chronic illness might be the result. With Ananke’s influence, illness can be fated, part of destiny. We might be considering genetic illnesses, here, for example.
Ananke’s children, Chaos and Aether also may have a bearing on illness. Chaos demands answers to questions such as ‘how can I breathe in this situation? How can I find the space to express my humanity? There might be situations where people need to break free of constraints, and to find a new way to live before they can stabilise health issues. Chaos is around whenever people are feeling held back from making great leaps forward. In the hesitation of making these steps, illness can arise. Chaos may influence many emotional and mental illnesses; fevers and inflammations; symptoms that come and go, and situations where there is drama and confusion. Chaos has particular influence on artistic and creative people.
Aether brings splitting – the person in question needs ‘special air’ and cannot ‘breathe’ the same air as people who are healthy. The effect can be ‘depersonalisation’; with illnesses of oversensitivity, allergies, and lack of energy; often with a sense of being ethereal. Post viral fatigue, M.E, and situations where people need to withdraw from the world, and may become passive, are under the influence of Aether. So Chronos brings the element of Time, Ananke invokes Destiny, Chaos demands space to breathe and express the personality, and Aether brings the capacity to split off, in order to survive intractable situations.
The Pattern of Illness through our life
It is said that introverts retreat into infections, which allow them to withdraw from the world, and rest, alone; so they are under the influence of Aether. Extroverts go breaking their limbs, and have accidents, often caused by other people. They have projected their dis-ease out onto the world, and it comes back to them, in the form of an event. They are under the influence of Chaos. This is a wild generalisation, of course, but some people notice some truth in it. So, it is helpful to look at the pattern of illness through our life. Tracking this pattern can give us an insight. Is there a story thread through our life – a tendency to some particular sorts of illness, or illness occurring at some particular time of the year? Are there repeating patterns through families, from one generation to the next? It is helpful to look at illness in context –
I suffered a …… in the context of ….. and the consequence was …..
To give a personal example, ‘I suffered acute appendicitis when I was 9. This context was that I was at the time unable to digest the rage of my family situation. The consequence was a near death experience that led, ultimately, to my career as a psychotherapist.
Reflecting now, I can see that I got ill when everyone else got tense, and so my body was acting as a barometer to family stress. I was somatising the lack of harmony in my family, and ultimately my silent rage led to acute appendicitis.
The Factor of Stress
We know that stress has an effect on the immune system, and the nervous system. For the greater part, stress arises in the emotions and the mental life. Factors like grief, insecurity, anxiety, and worry have a measurable effect on the chemistry of our body. Equally meditation, relaxation and mindfulness have a measureable effect on stress reduction, and therefore wellbeing, within our body.
If stresses of life lead to the gap between body and mind/emotions/soul becoming insupportable, this will lead to symptoms arising. This can be where illness is understood as dis-ease, a lack of ease in our life.
Experience at the Bristol Cancer Help Centre (now Penny Brohn Cancer Care) showed us that generally it takes 18 months to two years between an emotional precursor and the diagnosis of cancer. This is not to say that all cancers have their roots in emotions, but that where there is a significant emotional event in that time scale, the patient may privately believe that there is a connection between the two events. One theoretical explanation is that the event lowered the immune system, sufficient for the cancer to take hold. (We all have cancer cells in our bodies all the time, normally safely dealt with by the immune system). It sometimes happens that an event many years ago will stay dormant in the body and the psyche, but may be triggered by a more recent event, leading to the occurrence of cancer. An example would be a woman I worked with who had cancer of the uterus. Her relationship had broken down two years before, and she felt that there was nothing left to live for. Behind that, was a story of an illegal termination of a teenage pregnancy, 40 years ago, with all the shame, grief and trauma that accompanied that event. When she made the connection between the termination and her current uterine cancer, she was able to make a narrative that made sense of her situation, and to find a way forward.
The Pace of Change
Change is easiest to adapt to if it happens slowly, at human soul’s pace. Sudden change can be shocking and traumatic. So we should not expect a rapid, instant, return to health, but a gradual increase in life force, and the capacity to cope with the everyday. I usually ask my clients to use self- assessment measurements for the frequency, intensity and duration of their symptoms. Out of a possible score of ten per measurement, total of thirty, clients can start to see an encouraging decrease in the scores, as the symptoms gradually become less frequent, less intense and are of shorter duration. We also look at marginal gains together. In sports psychology marginal gains are all the small changes that add up to a 1% change in performance. The most famous example of this is the British Olympic Cycling team of 2012 – but the same principle is used in business, education, and coaching. If you draw an aggregated 1% curve, the difference is obvious over time, but at the start, the difference appears to be miniscule. This is an encouraging model for returning to health, because there is no pressure to notice instant results. It is also a helpful approach when working with a multi-disciplinary team, because I can reasonably claim that my ‘territory’ is in the ‘1%-2% area’, leaving 98% to modern medicine. When change happens slowly it is easy to assimilate, and tends to embed itself in the body.
As we go through life, our bodies make marks – scars, wrinkles, weight, bends and distortions – the graphic history of our lives is drawn on our skin. The scars and scarifying, initiations, the marks left by accidents, the operations we’ve had; piercings and tattoos; how we stand, the ways our body reflects if we have been bent out of shape. Stretch marks; defensive stances; armoured chests. And the wounds that we carry inside, silently, that make no visible mark, but hang around us, changing our responses to the world, and perhaps are hinted at in a worry lines, or a pale complexion. We all have them, in some measure. And they all have a story to tell.
If we have a significant trauma, that we are unable to process, we tend to store it in our body. We encapsulate it with life force, so that it is well protected and we are protected from it, and from its repercussions. This works well enough for a while. But in time, we start to miss the life force that we have put around the issue, and the issue starts trying to draw attention to itself, and more life force is needed to suppress its messages. We might not recognise that we are not alive as we were, but if prompted, we might see that our thoughts return to this event; or that life has not flowed as well since the trauma. Part of us lives in the past, and the more time from this event in the past to the present time, the more difficult the situation becomes. Again, we are looking at the gap in time between the traumatic event and the present day. We might become inflexible, rigid, ossified. The unrecognised pain might hint at its existence in our frown, or in a tendency to bile and bitterness. If the gap becomes insupportable, a symptom will arise. When the message of the symptom, in this case, the trauma, is understood and sorted, life force can flow again, and we can live again in the present, instead of being stuck in the traumas of the past.
Constellations and Symptoms
When I was first introduced to constellations as a technique, I was puzzled about how I could integrate this with psychotherapy. I now realise that many therapists share this puzzle, and some resolve it by choosing to focus on one technique, rather than the other. This means that some psychotherapists become constellators, and leave psychotherapy; or choose to remain as psychotherapists, using constellation techniques rather sparingly. However, if one is working with body issues, this choice is rather easier.
One of my cupboards with constellation figurines. Yaks, men, women, and miscellaneous figures.
In the usual way of setting up constellations, the field of the issue holder is an area delineated by the circle of representatives. But what if the body is the field, and the ‘representatives’ are the symptoms? When I am working with a client with health issues on a one-to-one basis, their body is the field and their symptoms are representatives, which can be listened to in many ways. From the perspective of transpersonal psychology, it is helpful to ask questions that explore and amplify the voice of the symptom. The client can tell me if a symptom is better or worse, or they can draw an image of the symptom, they can name it, give it an age, say who it really belongs to, what helps, what makes it worse, where would it like to go, what would it like to become? Then I can bring in the constellation techniques, by modelling the situation on the floor with felts or figurines, and I can gather the usual information that is helpful to constellators; looking at eyelines, proximity, immediate family and ancestors, entanglements and exclusions. The orders of love, loyalties, and taking on the fate of others will play out in the field of the body, and be represented by symptoms, and this information can also be collected by observing and interpreting the positioning of figurines, and by questioning the client. Then by suggesting movements of the figurines, and perhaps interventions such as bowing, repeated sentences, and putting in healthy boundaries, the client can see possible solutions, and different ways of being that bring peace to the system. This is an important step towards better health. As an example, a client with persistent migraines, was leaving a dysfunctional relationship, and starting a new life. In a one-to-one constellation for her, we put in boundaries between the old life and the new, and focussed her life force and attention in the present. That led to less anxiety about the changes and in turn, to a reduction of tension in her jaw, which led to a reduction of the migraines. This work was in the context of the multi-disciplinary Headache Clinic in Yeovil, so my psychotherapeutic and constellations interventions were in tandem with appropriate chiropractic and orthodontic treatment.
In this constellation, the client and her previous partner are in the background. The boundary is held by yaks (always a popular choice in my cupboard of figures) and my client and her new partner are in the foreground.
Various angels that I use in constellations. They can stand in for Angels or Guardian angels; for Destiny, or What Would Help
Partnership with the Body
Symptoms can be seen as an active creative expression of dis-ease. There is a contrast between the hierarchical western medicine attitude, where the doctor and pharmacology industry knows best, and we must take their medicine, no matter what the cost. Instead, we need to have compassion, understanding, and a gentle listening ear to the body, and to be prepared to make the appropriate changes to support a return to health and wholeness. In other words, the approach becomes collaborative, rather than adversarial. In an ideal world constellations and psychotherapy can work in tandem with the western medical model, so that the body can be supported by the best of western medicine, whilst the soul can be nurtured out of a state of dis-ease and supported towards renewed health and wholeness in the body. Intuition is then partnered with intellect.
What does our body need? To be lived in, well fed, exercised and rested. To be loved, appreciated and cherished. To have opportunities for play, creativity and curiosity. To lead a life that is authentic. The body doesn’t need to be subservient to emotions, to be beaten up, shamed or punished. It doesn’t need to be the dustbin of all the issues we are reluctant to face and sort out. With this new orientation we can become closer to the voice of our soul; and find a path to healthy living that is congruent with our needs, not with a generalised ideal. We can become more embodied, and hence have better energy and metabolism. We can be more effective and more present in the world. At this point, the word ‘health’ meets its derivation of ‘whole’, and health and wholeness can start to be at one.
UKCP registered transpersonal psychotherapist and supervisor