Analytical body psychotherapy

1. Introduction

Version followed: the German-language Analytische Körperpsychotherapie (AKP) of Peter Geißler (Vienna) and Günter Heisterkamp (Germany; Adlerian, "leibfundierte analytische Psychotherapie"), as laid out in Geißler & Heisterkamp, Einführung in die analytische Körperpsychotherapie (2013), Geißler, Psychodynamische Körperpsychotherapie (2017), and Geißler's practice books Körperarbeit in der Psychotherapie (2023) and Der Körper als Ressource in der Psychotherapie (2025). Only publisher reading samples, tables of contents, reviews, interviews and conference reports of these are drawn on, not the full books; procedural detail below is therefore partly reconstructed and tagged. [source: Geißler & Heisterkamp 2013 sample; Geißler 2017 front matter; Geißler 2023 and 2025 samples] [uncertain: the name "analytical body psychotherapy" is assumed to mean this school; the term is occasionally used loosely for other psychodynamic body work]

What it is: a psychoanalytic (psychodynamic, in Heisterkamp's case Adlerian) psychotherapy that keeps the analytic frame, transference and countertransference work, but can temporarily or permanently "open the setting" beyond chair or couch so that bodily experience, movement, eye contact, voice, distance and, where agreed, touch enter the dialogue. It is a school and training tradition rather than a manualised protocol: it grew from the 1980s on among body psychotherapists trained in Reich's and Lowen's (bioenergetic) methods who turned to the therapeutic relationship, and among psychoanalysts (Heisterkamp, Tilmann Moser, Kurt Hemmer and others) who brought the body into analysis; forerunners named are Ferenczi, Balint and Winnicott. Organisational homes: the German Steißlinger Kreis and the Austrian Arbeitskreis für analytische Körperpsychotherapie (AKP; now inactive as an association, continuing as an intervision group), the Viennese symposia "Psychoanalyse und Körper" and the journal Psychoanalyse & Körper (ed. Geißler). [source: Geißler 2011 BÖP article; Willerscheidt interview 2017; Geißler & Rieken 2017 sample; Klopstech 2008 review]

How change happens (the school's view): human development is relational from birth (the "competent infant" co-shaping contact), so early, preverbal relational patterns are stored as implicit, bodily "relational knowing" and are re-enacted in the present between patient and analyst. When these bodily-scenic interactions (action dialogues, enactments) are noticed, lived through differently and then understood together, new experience becomes available for representation and mentalisation, a "corrective emotional experience" aimed at structural change of unconscious patterns rather than symptom exercises. [source: Geißler 2011; Willerscheidt interview 2017; Geißler 2025 sample]

2. Framework

The school publishes no fixed session protocol. Three levels of structure can be identified. [source: Geißler & Heisterkamp 2013 sample; Geißler 2017 front matter; Geißler 2023 sample]

Format and length. Individual long-term psychodynamic or analytic therapy (also group therapy, child and adolescent therapy, inpatient care; named special fields: anorexia nervosa, borderline disorders, "scenic supervision"). Reported courses run for years: e.g. two years of talking therapy before the setting was opened; another process lasting about eight years; an analyst who kept the classical couch setting for several years before moving beside the couch and then face to face. No session count is given in the sources. [source: Geißler & Heisterkamp 2013 contents; Kuck 2023 Ärzteblatt report] [uncertain: frequency and session length not given; in German-speaking practice they follow the analytic or depth-psychological frame the clinician works in (typically 50-minute sessions, 1–3 per week) [synthesis]]

Macro-level: verbal setting, opened setting, return.

Verbal frame and working alliance. Treatment starts in the usual seated or couch setting; frame, working alliance, atmosphere and indication/contraindication are clarified (Geißler 2013 ch. 4; 2017 ch. 5.2). Goal: a stable alliance and an understanding of the transference.
Opening the setting ("Settingöffnung"): temporarily or permanently giving up the seating or couch arrangement to reach an experiential layer that talk does not reach; both patient and therapist leave the familiar "safe space". Typical triggers in the case material: a long verbal standstill, preverbal or structural deficits, patients who have fallen silent in emptiness. [source: Geißler 2023 sample; Kuck 2023]
Return to reflection. Every bodily sequence is followed by verbal processing; the setting may close again. [source: Kuck 2017; Willerscheidt interview 2017]

Criteria for opening (sources): the open setting does not guarantee a productive process and needs a "hohes Maß an Abstimmung" (high degree of attunement) with the patient's structure, the timing and the therapist's qualification. [source: Geißler 2025 sample] Added criteria [synthesis]: the patient can name and tolerate bodily sensations without dissociating; the transference is not acutely eroticised or persecutory; the patient can say no; the therapist has supervision on the case.

Micro-level: Heisterkamp's process sequence. The 2013 textbook organises the course of a body-related episode in six steps (chapter headings): Herausbildung (emergence), Anspielung und Vertiefung (allusion and deepening), Bereitstellung und Vorstellung (making available and imagining), Abstimmung und Modellierung (attunement and shaping), Erprobung (trying out), Nacherfassung (subsequent grasping/reflection). [source: Geißler & Heisterkamp 2013 contents] [uncertain: chapter text; the working meanings below are a reading of the headings combined with Geißler's 2023 technique sequence, and are marked synthesis]

Emergence: a theme shows itself in posture, gesture, voice or an enactment; goal: notice it, do not interpret yet. Move on when it recurs or the patient senses it too. [synthesis]
Allusion and deepening: the therapist points to it lightly ("alludes") and invites the patient to stay with it; goal: experiential density. Move on when an action impulse or wish appears. [synthesis]
Making available and imagining: the therapist offers a possible concrete action (a position, a distance, a contact) and the patient first imagines it; goal: test the fantasy before acting. Move on only on the patient's clear yes. [synthesis]
Attunement and shaping: patient and therapist jointly adjust the form (where, how close, how long, who leads). [synthesis]
Trying out: the action is carried out as a Handlungsprobe (action trial). [source for the term: Geißler & Heisterkamp 2013 sample]
Subsequent reflection: the experience is put into words, linked to history and transference. [synthesis on detail]

Geißler's teaching sequence of techniques runs parallel: perception-centring → from body perception to movement → from fantasy to concrete interaction, with resistance work as a fourth technique; the 2017 book adds graded "action levels": eye contact, vocal expression, proximity and distance, physical touch, and intended bodily-scenic interaction. [source: Geißler 2023 contents; Geißler 2017 contents]

3. Guiding principles

[source for this section: Geißler & Heisterkamp 2013 sample; Geißler 2011; Geißler 2017 contents; Geißler 2023 and 2025 samples; Klopstech 2008; Willerscheidt 2017 (interview and ZfPFI); Kuck 2017 and 2023]

Relational anthropology. Development starts in a shared field, not from a drive. → Read every bodily phenomenon as part of the current relationship, not as an isolated "block".
The body in action, here and now. The focus is the body as carrier of communication in the dyad in the present moment. → Watch what happens between you, not only what the patient reports.
No exercises are "applied". The 2013 text states "Hierbei werden keine Übungen »eingesetzt« oder »angewendet«." → Every bodily intervention must grow out of the current scene; never run a body routine to a plan.
Perception-centring of both bodies. The therapist attends systematically to their own and the patient's movements. → Track your own posture, breath and impulses as data.
Do not verbalise too early. Premature interpretation can block the psychic process. → Let a bodily sequence complete before you explain it.
Pace by the patient's experiential process. Especially with unstable self-boundaries, flooding, or patients who adapt to imagined expectations. → Slow down, make smaller offers, check compliance.
Enactments are the material. Enactments are unconscious, unintended action dialogues; one is quoted as saying "Wer sich nicht verwickeln lässt, der spielt keine Rolle" (whoever avoids entanglement plays no part). → Expect to be drawn in; your "mistakes" are a route to early distress.
Interactional transference analysis; action as a source of insight. → Analyse transference in what is done together, not only in what is said.
Implicit relational knowledge and reciprocal body reading. → Assume both of you read each other's bodies continuously, mostly outside awareness.
Life movement and moving-with (Heisterkamp; Adler's "Lebensbewegung"). → Understand symptoms as a person's movement toward or away from others, and move with it before shaping it.
Present-moment understanding ("präsentisches Verstehen") and operative participation ("operative Teilhabe": responding in action to provocative acting-out, especially with children). → Sometimes the right reply is an action, then reflection.
Abstinence is re-examined, not abandoned. The analyst becomes literally "touchable". → Keep the asymmetry and your own needs out of the action; reflect on gratification.
Setting conditions matter as much as stance. A colleague cites Gindler: "Mache dich erfahrbereit" (make yourself ready to experience). → Room, mat, cushions and your own embodied readiness are part of the technique.
Touch must fit both. Whether touch fits is always clarified for both people in view of transference and countertransference. → No touch you are inwardly unsure of.
Expanded countertransference capacity and containment. → Your job is to feel strong affect bodily and stay steady, not to stop the process.
Corrective emotional experience leading to reflection. → Each lived sequence must be put into words afterwards.
Process, not intervention list; structural change. → Judge success by changed patterns of relating over time, not by catharsis in a session.
Patient keeps initiative and the last word. Heisterkamp let patients set initiative and pace and published patients' own follow-up accounts. → Ask the patient what helped and what did not.

4. Intervention inventory

How to read this inventory. AKP explicitly rejects a catalogue of exercises "applied" to patients; what its authors describe are levels of action and process moves that arise from the scene. The items below are those named in the sources (chapter headings of Geißler 2013, 2017, 2023, 2025; case vignettes in Kuck 2017 and 2023; Willerscheidt 2017). Where only a heading was available, the steps are my reconstruction and tagged [synthesis]. Durations and repetitions are not given in any source. [source: Geißler & Heisterkamp 2013 sample; Geißler 2017 contents; Geißler 2023 contents] Tilmann Moser's named touch-based exercises ("climbing tree", "bull fight") are mentioned in the Willerscheidt interview but not described; they are not reconstructed here. [uncertain]

Touch: requirements for every item that uses it. Touch requires specific training in body psychotherapy, regular supervision and a check of what your licence, professional code and jurisdiction allow; Geißler's 2023 book has a chapter on requirements, training and supervision, and his 2025 edited book includes a first draft of professional touch guidelines. [source: Geißler 2023 contents; Rabenstein 2025 review] Consent steps given by the sources: clarify whether touch fits for both people in view of transference and countertransference [source: Kuck 2023]; let the patient set initiative and pace and try touch first in silence [source: Kuck 2017]; offer rather than impose (offers can be declined; a patient asked permission before hugging) [source: Kuck 2023; Willerscheidt interview 2017]. Added steps [synthesis]: (1) explain in advance what touch might be used for and that it is always optional; (2) ask for each specific touch (where, how, how long) and wait for a clear verbal yes; (3) offer a no-touch alternative (imagined contact, self-touch, an object such as a cushion between you); (4) agree a stop signal (word or gesture) and honour it instantly; (5) check in during ("still all right?") and afterwards; (6) only non-intimate areas (hands, forearms, shoulders, upper back); sexual or genital touch is never a technique; (7) document the agreement and discuss every new form of touch in supervision.

4.1 Preparing the room and equipment

Purpose: make an open setting possible and safe before it is needed. [source: Geißler 2023 contents: "what a body-oriented practice needs (space, equipment, tools)"; Geißler 2017 ch. 5.1]
Steps [synthesis on detail]: (1) Provide floor space beyond chairs and couch; a mat (one patient "found her place on a mat" [source: Kuck 2023]); cushions; a firm cushion or foam bat for aggression work [source: Willerscheidt interview 2017]; movable chairs. (2) Arrange so the patient can always see the door and move away. (3) Tell new patients at intake that the room allows work beyond talking and that nothing happens without agreement.
Example language (illustrative): "You'll see there's space here to stand or move. We may never use it; if we do, it will always be something we agree on together."
Watch for: patients who feel pressured by the equipment; keep it unobtrusive.

4.2 Frame, working alliance and indication check

Purpose: decide whether and when an opened setting suits this patient. [source: Geißler & Heisterkamp 2013 ch. 4 heading; Geißler 2017 ch. 5.2; Geißler 2025 sample]
Steps [synthesis]: (1) Work verbally first and form a working hypothesis of the core relational pattern and transference. (2) Assess ego strength, self-boundaries, tendency to flood, dissociation, compliance, history of abuse or boundary violation, psychosis, current crises. (3) Discuss the possibility of bodily work explicitly; agree that it can be paused or stopped at any time. (4) Check your own countertransference and qualifications.
Indications named: potentially most patients, especially structural deficits from the preverbal period; also trauma, dissociation, depression with emptiness, anorexia, borderline disorders, children. [source: Geißler 2023 sample (Hofer-Moser foreword); Kuck 2023; Geißler & Heisterkamp 2013 contents] Contraindications are a chapter heading in 2013 and 2023. [uncertain]
Example language (illustrative): "Sometimes what we keep circling in words is easier to feel in how we sit or move. If you're curious, we could try small steps; if not, we stay as we are."
Watch for: eager agreement from patients who habitually please; treat as material, not consent.

4.3 Opening the setting (Settingöffnung)

Purpose: reach an experiential dimension not accessible in the face-to-face or couch arrangement; used temporarily or permanently. [source: Geißler 2023 sample]
When: verbal standstill (in one case after two years), preverbal themes, silent emptiness. [source: Kuck 2023]
Steps [synthesis on detail]: (1) Name what you notice (a repeated posture, the stuckness). (2) Propose a minimal change: standing, turning the chairs, sitting on the floor, moving to the mat, or the patient choosing a place in the room. (3) Let the patient choose position and distance; one patient took an embryonic position on the mat. [source: Kuck 2023] (4) Proceed with perception-centring (4.4). (5) Close by returning to the chairs or couch and reflecting (4.20).
Example language (illustrative): "Would you like to find a place in the room where you'd rather be right now? You can take your time and change it."
Watch for: the patient's experience of leaving the "safe space" (it applies to you too) [source: Geißler 2023 sample]; collapse, freezing or excitement; relief or new associations indicate it is working.

4.4 Perception-centring (Wahrnehmungszentrierung)

Purpose: build a body-language dialogue by attending to the patient's and your own bodily movements, without blocking the process through premature verbalising. First technique in Geißler's sequence. [source: Geißler & Heisterkamp 2013 sample; Geißler 2023 contents; Geißler 2023 sample on "eigenleibliches Spüren"]
Steps [synthesis on detail]: (1) Patient sits, stands or lies as chosen. (2) Invite attention to one area of sensation at a time (contact with the floor, breath, hands, a tension already noticed). (3) Ask for description, not explanation (temperature, pressure, movement impulse, image). (4) Simultaneously track your own body (posture, breath, impulses, tiredness) as countertransference. (5) Leave silences; reflect back briefly. (6) Note any spontaneous movement impulse (leads to 4.5).
Example language (illustrative): "Just notice what's there in your body right now, without needing to change it." "What happens in your hands as you say that?"
Watch for: flooding or dissociation (glazed look, losing contact) → return to eyes open, feet, room orientation; working signs: more precise descriptions, emerging feelings or memories.

4.5 From body perception to movement

Purpose: let a sensed impulse unfold as movement, so the "life movement" (toward, away, against) becomes visible and can be completed. [source: Geißler 2023 contents; Geißler 2017 ch. 5.4; Willerscheidt ZfPFI 2017 on Lebensbewegung]
Steps [synthesis on detail]: (1) Pick up a small movement (a hand closing, a shift backward). (2) Invite the patient to allow it slightly more, slowly. (3) Ask what the movement "wants" or toward whom it goes. (4) Optionally invite the opposite movement for contrast. (5) Stop at a natural endpoint; sit and reflect.
Example language (illustrative): "Your hand keeps pulling back. Would you let it do that a little more, slowly, and see where it wants to go?"
Watch for: frozen, interrupted action sequences (described in defensive systems) [source: Geißler 2023 sample, Hofer-Moser foreword]; force or speed escalating → slow down.

4.6 From fantasy to concrete interaction (action trial, Handlungsprobe)

Purpose: turn a relational fantasy (wish to be held, to push away, to be seen) into a carefully shaped, real interaction with the therapist, then reflect it. Third technique in Geißler's sequence; corresponds to Heisterkamp's "making available → attunement → trying out". [source: Geißler 2023 contents; Geißler 2017 ch. 5.3; Geißler & Heisterkamp 2013 sample]
Steps [synthesis on detail]: (1) Identify the fantasy as it appears in words or body. (2) Ask the patient to imagine the interaction concretely first and notice their body while imagining. (3) If wanted, agree the form (position, distance, contact or no contact, who leads, length, stop signal). (4) Carry it out slowly, briefly; the patient can modify it. (5) End explicitly; return to seats. (6) Reflect: what was felt, what is familiar, what was new, what it says about the transference.
Example language (illustrative): "You've said you'd like someone to just stay next to you. Could you imagine me sitting beside you, and notice what happens? Then we can decide whether to try it."
Watch for: gratification replacing understanding; compliance; disappointment that reality differs from the fantasy (valuable material).

4.7 Eye contact

Purpose: action level for regulating contact and exploring being seen. [source: Geißler 2017 ch. 5.5 heading] [steps synthesis]
Steps: (1) Notice gaze patterns (avoidance, staring). (2) Invite experimenting: brief contact, looking away, looking again, at a chosen distance. (3) Ask about sensations and associations.
Example language (illustrative): "Try looking at me for a moment and then away whenever you need to. What do you notice?"
Watch for: shame, freezing; let the patient control duration.

4.8 Vocal expression

Purpose: action level using sound, volume, rhythm and melody. [source: Geißler 2017 ch. 5.6 heading; Kuck 2023 (work through rhythm and speech melody with a patient who could not speak)] [steps synthesis]
Steps: (1) Attend to the patient's voice (thin, held, flat). (2) Mirror rhythm or tone in your own speech. (3) Invite a sound, a word said louder or softer, a sigh, or saying "no" in different ways.
Example language (illustrative): "Say that once more, and let your voice be as loud as it feels inside."
Watch for: loud cries can emerge late in long processes (one after about eight years) [source: Kuck 2023]; never push for volume.

4.9 Proximity and distance

Purpose: action level exploring closeness, boundaries and space. [source: Geißler 2017 ch. 5.7 heading] [steps synthesis]
Steps: (1) Patient stands or sits; therapist at a moderate distance. (2) Patient directs the therapist (closer, stop, back) or moves themself. (3) Notice the bodily signal for "right distance" and "too close". (4) Reflect on links to early relationships.
Example language (illustrative): "Tell me to come closer or stop, and we'll find where it feels right for you."
Watch for: patients who cannot say stop; practise the stop itself as the intervention.

4.10 Touch trial (Berührungsprobe)

Purpose: action level of physical touch, used when a bodily-relational need cannot be reached otherwise (holding, support, presence). [source: Geißler 2017 ch. 5.8 heading; Kuck 2023; Rabenstein 2025 review] Apply the touch requirements above.
Case examples from the sources: a hand held during regression or intense grief [source: Kuck 2017; Willerscheidt interview 2017]; a shoulder touch offered to a depressive patient [source: Kuck 2023]; a touch to the tailbone in a long treatment, after clarifying fit for both [source: Kuck 2023] (a sensitive area: I would not use it outside expert supervision [synthesis]); carefully considered touch trials with a child [source: Kuck 2023].
Steps [synthesis on detail]: (1) The need emerges from the process, not your plan. (2) Clarify inwardly whether it fits for you as well. (3) Offer verbally, with specifics and alternatives. (4) Patient chooses; begin with the lightest form (e.g. hand on the forearm or between the shoulder blades [source for this pairing in training: Kuck 2017]); in silence if agreed. (5) Check in; end gently, announcing the end. (6) Reflect, including the ending of contact.
Example language (illustrative): "Would it help if I put my hand on your shoulder for a moment? You can say no, or we can try something else."
Watch for: the ending of touch can be experienced as catastrophic (one patient then refused touch altogether) [source: Kuck 2023]; regression; erotisation; your own wish to comfort.

4.11 Self-touch as a bridge

Purpose: give a patient who rejects being touched a self-directed bodily experience in the therapist's presence. [source: Kuck 2023 (Motzkau case: a patient massaged her own cold feet "together with" the therapist, experienced as calming and connecting); Rabenstein 2025 review (self-touch as "Idiopraxie")]
Steps [synthesis on detail]: (1) Respect the refusal of touch fully. (2) Pick up a bodily need the patient names (cold feet, tension). (3) Invite self-touch (rubbing, holding, pressing) at the patient's own pace; the therapist can do the same on themself in parallel, without touching the patient. (4) Track sensations and the relational feeling of doing it together. (5) Reflect.
Example language (illustrative): "You don't want to be touched, and that's fine. Would you like to warm your feet with your own hands while I do the same with mine?"
Watch for: shame about self-care; parallel activity often reduces it.

4.12 "Touch without touch"

Purpose: contact via facial expression, gesture, rhythm and speech melody, then an action dialogue with metaphors, when physical touch is not indicated or the patient cannot speak. Presented as an alternative route, not a substitute. [source: Kuck 2023 (Kobylinska-Dehe)]
Steps [synthesis on detail]: (1) Attune your facial expression and gestures to the patient's. (2) Match and gently modulate rhythm and tempo. (3) Offer images or metaphors for the contact ("as if I were holding the space for you"). (4) Reflect on what reached the patient.
Example language (illustrative): "It doesn't need words right now. I'm here, at this distance, keeping you company."
Watch for: a felt sense of connection, softening, eventual speech.

4.13 Staying with and holding in grief

Purpose: bodily holding when grief or regression becomes intense. [source: Kuck 2017 (analyst took the patient's hand during a regression to an early scene, experienced as a corrective experience); Willerscheidt interview 2017 (hand held during intense grief)] Apply touch requirements.
Steps [synthesis on detail]: (1) Stay present, slow your breathing, do not rush to talk. (2) If the patient reaches out or the need is clear, offer a hand. (3) Hold steadily, without stroking or moving. (4) Let the wave pass; announce release. (5) Later, reflect on what it meant.
Example language (illustrative): "I'm here. You can take my hand if you want."
Watch for: a co-therapist or the therapist wanting to stop the grief rather than accompany it [source: Willerscheidt interview 2017]; dependence on holding.

4.14 From imagined safe contact to real contact

Purpose: build safety through imagery before any physical interaction (used with severe trauma and dissociation). [source: Kuck 2023 (Sogl: imagining safe contact with a bear, later a bodily interaction in which the patient could lean in; drawings made experience communicable); Geißler & Heisterkamp 2013 sample (Ware's "active imagination")]
Steps [synthesis on detail]: (1) Invite an image of a safe, protective figure. (2) Explore its qualities and the body sensations it evokes. (3) Optionally draw or paint it. (4) Only much later, and if wanted, offer a concrete, small form of the same quality (e.g. leaning back against a cushion held by the therapist, or shoulder-to-shoulder sitting). (5) Reflect.
Example language (illustrative): "Imagine something or someone strong and kind beside you. Where is it? What happens in your body?"
Watch for: intrusion of trauma images → return to orientation; the patient's own pace.

4.15 Intended bodily-scenic interaction (staging a scene)

Purpose: deliberately act out a relational scene (e.g. separation) to experience and understand it, rather than only talk. [source: Geißler 2017 ch. 5.9 heading; Kuck 2023 (Scharff: separation scene in which the analyst said he would leave and the patient clung to his arm); Geißler & Heisterkamp 2013 sample ("Inszenierung", draws on psychodrama and bioenergetics, integrated differently)]
Steps [synthesis on detail]: (1) Agree on the scene and roles in words. (2) Agree physical limits and stop signal. (3) Play briefly, with the therapist in a role close to the transference. (4) Step out of role explicitly ("I'm back as myself"). (5) Reflect on what was felt on both sides.
Example language (illustrative): "Shall we try it: I say I'm leaving, and you notice what you want to do. We stop whenever you say."
Watch for: forceful clinging (the therapist had to pull away in the vignette) → agree beforehand how ending will happen; role confusion; retraumatisation.

4.16 Working with spontaneous enactments (action dialogue; operative participation)

Purpose: use unconscious, unplanned action dialogues as access to early distress. [source: Geißler 2025 sample; Willerscheidt ZfPFI 2017 (Heisterkamp's Handlungsdialog, operative Teilhabe, enactment); Reinert 2017]
Steps [synthesis on detail]: (1) Notice when you are acting unusually (moving your chair, interrupting, being late, a slip). (2) Contain it; do not hurry to correct. (3) Explore jointly what just happened between you, in the body. (4) Link it to the patient's patterns and the transference. (5) With children, respond first in action (e.g. joining the game) and reflect later.
Example language (illustrative): "I just leaned back and away from you. What did you notice when that happened?"
Watch for: defensiveness in the therapist; treat "mistakes" as information.

4.17 Body-based countertransference fed back

Purpose: use the therapist's bodily reactions as data and, selectively, as cues for the patient's own sensing. [source: Kuck 2023 (Sogl); Willerscheidt interview 2017 (analyst first overwhelmed by own bodily reactions; "expanded countertransference capacity")]
Steps [synthesis on detail]: (1) Register your body (tightness, heaviness, nausea, impulse). (2) Decide whether disclosure helps the patient. (3) Offer it tentatively as your experience. (4) Invite the patient to check their own body.
Example language (illustrative): "As you told me that, I noticed my chest getting tight. I wonder what you notice in yours."
Watch for: burdening the patient with your feelings; keep disclosures brief and patient-focused.

4.18 Aggression against a protected surface

Purpose: allow aggressive impulses bodily expression in a safe form. Reported in self-experience: the patient struck a protective shield held by the therapist with a foam bat (bataka), then asked permission to hug the therapist. [source: Willerscheidt interview 2017; also pushing away and hitting a cushion in Kuck 2023 (Scharff)]
Contraindications and screening: not given in the sources [uncertain]. Before any cathartic discharge [synthesis]: screen out pregnancy, cardiovascular or respiratory illness, epilepsy, recent injury or surgery, psychosis, severe dissociation, active suicidality or homicidality, recent trauma without stabilisation, and patients for whom aggression escalates rather than settles.
Steps [synthesis on detail]: (1) Agree aim, limits (only the cushion or shield, no head-height swings), stop signal. (2) Patient stands, knees soft; therapist holds a large cushion firmly at a safe angle. (3) A few strikes, with voice if wanted; pause after each short sequence. (4) Stop at the first sign of disorganisation. (5) Sit, ground, reflect on what the anger is about and whom.
Example language (illustrative): "Hit the cushion as hard as feels right, and stop whenever you want. Notice what comes up."
Watch for: escalation, dissociation, shame afterwards; a request for closeness afterwards (handle per touch requirements).

4.19 Stepwise change of position in the couch setting

Purpose: gradually open a classical setting when a patient falls silent in emptiness. [source: Kuck 2023 (Scharff: years on the couch, then sitting beside the couch, later face to face)]
Steps [synthesis on detail]: (1) Discuss the change. (2) Move your chair beside the couch. (3) Later move to face to face. (4) Reflect on each change.
Example language (illustrative): "I'd like to sit where you can see me. How would that be for you?"

4.20 Subsequent reflection (Nacherfassung)

Purpose: put lived bodily experience into words and link it to history and transference; the last of Heisterkamp's process steps. [source: Geißler & Heisterkamp 2013 contents; Kuck 2017 (reflection after silent touch led to childhood memories); Willerscheidt interview 2017] [steps synthesis]
Steps: (1) Return to seats. (2) Ask what was experienced, in sequence. (3) Ask what was familiar, what new. (4) Link to the relationship with you and early relationships. (5) Agree whether to return to it.
Example language (illustrative): "Let's go back over what happened, step by step. What stays with you?"
Watch for: skipping this step; insight that remains disconnected from the experience.

4.21 Resistance work

Purpose: fourth technique in Geißler's sequence; the 2013 book notes new forms of resistance in both patient and therapist (including countertransference resistance). [source: Geißler 2023 contents; Geißler & Heisterkamp 2013 sample] Chapter text not drawn on [uncertain]. Practical handling: see section 5.

4.22 Working with basic affects (including joy)

Purpose: the 2025 book treats basic affects (joy, lust, fear, grief, humiliation, anger, rage, disgust) as technical foci; Heisterkamp wrote on joy and the therapist's countertransference joy as part of the process. [source: Geißler 2025 sample; Willerscheidt ZfPFI 2017] Details not drawn on [uncertain]. [synthesis] Identify the affect in body and voice; use 4.4–4.9 to let it unfold at tolerable intensity; welcome positive affect as much as painful.

4.23 Children and adolescents: moving-with, action dialogues, touch trials

Purpose: Heisterkamp's "Mit-Bewegung" (moving-with), developed for rapidly shifting play scenes; considered touch trials with a child; touch is often unavoidable with children. [source: Willerscheidt ZfPFI 2017; Kuck 2023; Willerscheidt interview 2017] [steps synthesis] Join the child's movement and play, modulate it as in intuitive parenting, respond in action to provocations, then name what happened; agree touch with child and guardians.

4.24 Pair-contact exercises in groups and training

Purpose: self-experience for trainees and group work; simple pair contact (a hand between the shoulder blades, eye contact) quickly evoked intense feelings; long-term groups of crying, laughing and anger followed by reflection. [source: Kuck 2017; Kuck 2023 (Angermayr: trainees practise touch to perceive induced movements and sensations)] [steps synthesis] Explain, pair up, agree consent and stop signal per pair, short contact, share in pairs then in the group.

4.25 Scenic role-play supervision for touch anxiety

Purpose: help a therapist stuck with a patient. Heisterkamp offered only his foot to lightly touch the role-player's foot, letting the "patient" set initiative and pace, silently first, then reflecting; it evoked memories of longing for gentle touch and fear of rejection. [source: Kuck 2017; Geißler & Heisterkamp 2013 contents ("scenic supervision")]

4.26 Patient follow-up ("the last word to the patients")

Purpose: Heisterkamp's 2012 follow-up study had patients reflect on their experience of the body-based work. [source: Willerscheidt ZfPFI 2017] [synthesis] Periodically and at the end, ask what helped, what felt intrusive, and what they would change.

5. Handling problems

The sources name problems (resistance in patient and therapist, abstinence, regression, retraumatisation, sexualisation, destabilisation) but the chapters giving their solutions (Geißler 2013 on disturbances and countertransference resistance; Geißler 2023 on risks and contraindications; Geißler 2017 ch. 6) are not drawn on. Responses below are therefore mostly [synthesis] unless tagged otherwise. [source: Geißler & Heisterkamp 2013 sample; Geißler 2023 contents; Geißler 2017 contents; Kuck 2023]

Verbal standstill / stuck client. Sources: a two-year verbal standstill was the occasion to open the setting. [source: Kuck 2023] Response [synthesis]: before opening, check whether the stuckness is itself an enactment (4.16); then offer a minimal change (4.3) and perception-centring (4.4) rather than a large exercise.
Stuck in the opened setting. [synthesis] Return to chairs and talk; the open setting is not a guarantee of process (Geißler 2025). Ask what the body work has meant in the transference (e.g. performing for you).
Resistance. Named as a technique area and as "new forms of resistance" in both patient and therapist. [source: Geißler 2023 contents; Geißler & Heisterkamp 2013 sample] Response [synthesis]: treat refusal of bodily work as legitimate and as meaningful; explore it bodily ("how does no feel?") rather than override; examine your own reluctance or eagerness in supervision.
Refusal of touch. Use self-touch (4.11), touch without touch (4.12), imagery (4.14). [source: Kuck 2023] Note the open question raised at the 2023 symposium whether refusing a patient touch can itself be retraumatising. [source: Kuck 2023] [synthesis] Discuss your refusal openly when you decline a request.
Ending of contact experienced as catastrophic. One patient experienced the end of a shoulder touch so badly she wanted no more touch. [source: Kuck 2023] Response [synthesis]: announce endings in advance, end gradually, explore the separation experience as central material.
Overwhelm, flooding, dissociation. The 2013 text asks for pacing especially with unstable self-boundaries and flooding. [source: Geißler & Heisterkamp 2013 sample] Response [synthesis]: stop the action; eyes open; feet on floor; name five things in the room; sit up; slow, ordinary talk; reduce intensity next time (shorter, smaller, more distance). The PBSP tradition, close to this school, describes deliberately limiting intense material. [source: Psychoanalyse & Körper Nr. 30 sample]
Destabilisation of fragile patients. A colleague's patient showed a "psychotic core" after defences were overwhelmed; the reporting author saw no therapeutic value in this. [source: Kuck 2017] Response [synthesis]: screen for psychotic vulnerability; prefer containment and structure-building to defence-breaking; consult psychiatry if signs appear.
Regression. The question how quickly touch fosters regression was raised but not answered. [source: Kuck 2023] Response [synthesis]: use regression only within a stable frame and session time; always end with re-orientation and reflection (4.20); avoid gratifying dependency outside sessions.
Erotisation and sexual boundary risk. A holding experience on the couch led to a sexually charged movement; the therapist later presented it with shame and guilt. [source: Kuck 2023] The report names inner readiness, character strength and a fulfilled personal life as prerequisites for not crossing boundaries. [source: Kuck 2023] Response [synthesis]: stop the physical contact calmly; return to seated distance; name the shift without blame; reflect on transference; seek supervision the same week; document. Never continue or reintroduce body contact while it is erotically charged.
Compliance and pseudo-consent. The 2013 text flags patients who adapt to imagined expectations. [source: Geißler & Heisterkamp 2013 sample] Response [synthesis]: make "no" easy and rehearse it (4.9); pause between offer and action; watch for body signs contradicting a yes.
Therapist's own touch anxiety or wish to rescue. Addressed in training through scenic role-play supervision (4.25). [source: Kuck 2017] A co-therapist wanted to stop a grief process rather than accompany it. [source: Willerscheidt interview 2017] Response [synthesis]: personal body-psychotherapy self-experience and supervision; the sources note candidates are often "left alone" with touch questions. [source: Kuck 2023]
Ruptures. [synthesis] Bodily interventions that miss (too close, too fast) are enactments to be explored (4.16): acknowledge your part, ask how it felt in the body, re-establish distance, and work through it before any further body work.
Non-adherence. AKP prescribes no homework in the sources. [synthesis] Missed sessions or lateness after body work may signal shame or overwhelm; ask directly and slow the pace.
Aggression work escalating. [synthesis] End at once, ground, explore; see screening in 4.18. Do not use with patients with a history of violence without specialist risk assessment.
Suicidality and self-harm. [synthesis] Not addressed in sources. Suspend open-setting work; carry out a standard structured risk assessment, safety planning and lethal-means counselling (safe storage or removal), and involve medical services as required.
Physical illness. [synthesis] Body work is not a treatment for physical disease; refer for medical assessment of somatic symptoms.
Professional and legal limits. [synthesis] Check that body work and touch are within your licence and professional code; obtain written informed consent for the open setting; keep notes of every touch agreement; have supervision by someone trained in this approach.

Sources

Sources:

Further reading (full texts not drawn on):

Heisterkamp, G. (1993). Heilsame Berührungen. Praxis leibfundierter analytischer Psychotherapie.
Heisterkamp, G. (2002). Basales Verstehen. Handlungsdialoge in Psychotherapie und Psychoanalyse.
Geißler, P. & Heisterkamp, G. (Eds.) (2007). Psychoanalyse der Lebensbewegungen. Zum körperlichen Geschehen in der psychoanalytischen Therapie. Springer.
Geißler, P. & Heisterkamp, G. (2013). Einführung in die analytische Körperpsychotherapie. Psychosozial-Verlag.
Geißler, P. (2017). Psychodynamische Körperpsychotherapie. Vandenhoeck & Ruprecht.
Geißler, P. (2023). Körperarbeit in der Psychotherapie. Erste Schritte zur Öffnung des Settings. Psychosozial-Verlag.
Geißler, P. (Ed.) (2025). Berührung in der Psychotherapie. Vandenhoeck & Ruprecht.
Geißler, P. (2025). Der Körper als Ressource in der Psychotherapie. Psychosozial-Verlag.

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