What Is Psychomotor Therapy?

Thornquist E, Bunkan BH. Oslo, Norway, Norwegian University Press, 1991, paperback, 128 pp, $28.

What Is Psychomotor Therapy? is a book that takes its readers back to the basics. This Norwegian treatment was developed by Trygve Braatoy, a psychiatrist, and Aadel Bulow-Hansen, a physical therapist, in the 1940s and 1950s. At the time this approach surfaced, it was questioned and not widely used; however, now it is more accepted in the Scandinavian countries.

The authors, Thornquist and Bunkan, have written this book for physical therapists, physicians, and psychologists. This book represents the first attempt to introduce psychomotor treatment to a broader audience. The style of writing is stiff and stilted, probably because of the difficulty of translating from Norwegian to English, but the material is well organized.

Psychomotor therapy is used for the physical and emotional aspects of a patient. The process of change begins through posture, musculature, breathing, and the person's ability to adjust. This approach is developed with the theory that all feelings have physical expressions. The interaction between muscular and respiratory brakes is of central importance. For example, as a person who is afraid holds his or her breath in an expiratory position, the fight pattern of flexion, adduction, and medial (internal) rotation occurs. In contrast is the person who holds himself or herself together, stands up straight using his or her extensor system, and holds his or her breath in an inspiratory position.

The evaluation for psychomotor therapy includes a case history; an examination of respiration, posture, physical functions, muscles and other soft tissues, and autonomic functions and reactions; and the patient's reaction to the examination. No mention is made of evaluative tools such as a manual muscle test or use of goniometers, electromyography, thermal and galvanic skin response instruments, and so forth.

The indications for psychomotor therapy include strains and functional disturbances in the musculoskeletal system, but they also have been used for rheumatoid arthritis, high blood pressure, and asthma. The main contraindication is a person who shows an inability to adjust, such as a patient with an extreme psychiatric problem.

The primary aim of treatment is to improve a person's self-perception. The two main principles are to build the body from the bottom up (begin with the legs) and to always treat the whole body. The methods used are massage, exercise, and movement. The authors speak of postural adjustments, not corrections, and they address and compare their approach with the traditional posture treatment programs. In psychomotor therapy, posture changes occur more spontaneously and without the necessity of willpower, another form of tension. Massage and other specific techniques help to release breathing and stretch impulses. Every treatment session ends by helping the patient stand firm in a good, balanced position.

An important aspect of psychomotor therapy is body awareness, defined in this book as proprioceptive awareness. If a person is to alter bad habits, he or she must be aware of his or her own tensions and start to rediscover himself or herself.

Treatment, which begins with a contract, usually occurs once a week and takes time--months or years. Psychomotor treatment sometimes leads the patient to seek psychotherapy. The freeing of body and mind often allows patients to perceive issues and feelings that they have been holding back and that they now want to face and resolve. Other patients are able to resolve these issues without professional guidance during or after psychomotor therapy.

The challenge the authors present to the practitioners of this approach is to document and develop these theories further. The lack of quantitative diagnostic and treatment data will make this task difficult.

Psychomotor therapy would be enhanced by the sophisticated biofeedback instrumentation available today. These instruments, as a part of a treatment program, can improve a person's grasp of his or her own body awareness. One hopes that more will be written, researched, and taught on psychomotor therapy in the near future. This back-to-the-basics treatment of massage, breathing, and exercise has much appeal.

Mary Lee Bergcron, PT The Therapy Center Knoxville, Tenn