So many times I add unto his virtue

Ben Jonson, The Alchemist, II.iii. 106-107

This is from Rachel Remen's My Grandfather's Blessings (Riverhead Books 2000): "We heard something steadfast in the midst of our lives that had been there always, even before we were fully human. Our lives and all our lives depended on it. It was a profound and ineffable encounter with the mysterious."

The author is describing a group of physicians listening to their own hearts. There are several things about this brief description that I find compelling and directly connected to therapy, and this essay addresses all of them.

I have been thinking a lot lately about a chapter in Thomas Moore's book Original Self (HarperCollins 2000). At one point he says, " Humans often have a preference for straight lines. We think of evolution and human development as following a concrete path toward perfection. We expect our neighbors to walk the straight and narrow." The author goes on to quote the German poet Rilke; "I live in my life in widening rings." And goes on to say, "Maybe we should expect always to get into familiar trouble and to repeat both the glorious and defeating themes that are embedded in our soul."

Think of an ancient alchemist with a mortar and pestle. The slow, steady repetitive movement in circles was typical of the alchemist’s art. He would repeatedly perform the same action upon some element in an effort to alter it. Waiting patiently for subtle changes, he was convinced that it was the steadfast and unchanging nature of his action that would lead to success. These days, repetitive care of the same sort might be seen similarly. After all, can twenty consecutive visits to the therapist for the same modalities be explained in any other way?

Of course, when the same treatment done over and over doesn’t truly alter the problem in a therapeutic way, I have a problem with that kind of practice. Still, many perfectly reasonable therapists fall into this sort of pattern. They come to my classes worn out, somber and uneasy. They have no faith in the care they are providing their patients and admit that they wouldn’t trust it to help with their own chronically painful problems. Compelled to continue with the protocols that protect them financially, they are constantly in conflict with their original notion about what therapy was to be.

There is something to be said about the therapeutic aspects of repetition, though, and I think Remen’s description of the heartbeat alludes to this. If we find a way of being whose origins are instinctive and unconsciously driven, we will often find comfort in its familiar presence. Our heartbeat is an example of excitomotor activity, and it forms one of the three categories of nonconscious movement. Another of these, ideomotor, reflects our thoughts and/or our movement toward comfort. In my experience, when we become aware of it, it has a similar effect of calming combined with a sense of mystery.

The difference between repetitive care that gets us nowhere and repetitive activity that proves helpful is in its origin. Doing something to another over and over will help if that’s what they need, but movement toward correction, in my experience, must emerge unconsciously from the individual who is in pain. Therefore, we would be better off looking at the patient’s repetitive activity and considering how it might help if only it were allowed free reign. When someone’s isometric contraction of the muscle’s that drive speech becomes isotonic, they often say wonderfully therapeutic things. Why not the same for the isometric activity elsewhere in the muscles?

In their heyday, alchemists were often forced to work in secret. Their culture did not trust any mystery that didn’t have a religious origin, and the proper religion at that. I’m of the opinion that a remnant of this mistrust remains, and that the full expression of the unconscious is strictly prohibited, especially when bodily movement is concerned.

Imagine that each of us contains an internal alchemist. He (or she) expresses themselves through movement that originates in the unconscious They do so repetitively, and with a constancy that is inherent to life. When we listen to them, our behavior doesn’t display the straight evolutionary growth toward perfection that our culture seems to prefer, but, rather, a unique and idiosyncratic way of being in which we find comfort and stability. Perhaps these ways of being, gesturing and speaking get us into the “familiar trouble” Moore speaks of, but they define us, and, ultimately, lead us back toward the mystery within our own lives.

Perhaps therapists treating painful problems should consider this, and look for answers in the patient’s repetitive acts, and not their own.