The Value of Nudity in Therapy

My first introduction to the power of nudity was in therapy. I came west to a two-day workshop with William Hartman and Marilyn Fithian. Their main work was in sex therapy, but they also had this recurring workshop on body image which was conducted in the nude. I was so impressed by the changes this workshop helped me make that I returned to take a two-week course from them on doing nude therapy.

Hartman and Fithian did not invent nudity, of course. In the Hebrew Bible, there are many positive references to nudity. King David dancing nude before the Ark; several of the prophets lived for long periods in the nude. The early Christian church baptized with either the new convert alone or in some groups, the whole congregation removing their clothing, symbolically putting off their sinful nature. Many Celtic religions likely worshiped in the nude. In fact today, some Pagan religions do so, especially certain Wiccan covens who worship "skyclad." There is a good body of research showing the positive effects of social nudity on children as well as adults.

All this stems from the same factors that make nudity valuable in psychotherapy. (If you wonder why more therapists do not use nudity, that is the subject of another article. I think, but cannot prove, that many therapists are personally uncomfortable with nudity. Most of the professional therapy organizations are very conservative and wary of claims of sexual harassment. Much of this stems from the repressive nature of our conservative culture which insists on sexualizing nudity and then is anti-sex. That is my conjecture of course and not demonstrable fact.)

After my studies with these teachers, I have continued to learn to work with nudity in the context of body-mind practices and have become ever more aware that we "store" many of our emotions in our bodies. Obviously we do so in our tight chests, knotted muscles in necks and backs, but also internally in our digestive systems and elsewhere.

To speak of the value of nudity, we should say a few words of the value of clothing. Clothing serves several purposes: it protects our body from the elements. As we move toward fall and winter, we keep ourselves warm with clothing. It also protects us in our activities. We would not handle many construction materials or do other dangerous tasks without wearing the appropriate garments. Riding a motorcycle without protective clothing is foolish. A second and important use of clothing is to impress others or to project an image of our status, our interests or our wealth. The suit and tie of the business person is intended to project prosperity or the serious nature of endeavor.

But a major and insidious use of clothing is as psychological armor. We hide behind our clothing; unconsciously hiding our emotions, and especially our pain, not just from others but even from ourselves. In daily life constantly dwelling on our emotional difficulties would disrupt our day to day efforts at life, and actually reinforce our pain and struggle. However, while constantly focusing on emotions is not healthy, hiding them is equally unhealthy. Emotions need to be acknowledged and accepted. Healthy emotions can be an indicator that we are alive and well, even when they are painful as when we are sad or grieving. Unhealthy ones can be changed.

In my work with clients, I have learned to use nudity when it is an appropriate tool to discover and release emotions. This usually follows some period of discovering the more obvious and presenting issues that a client brings. Those are helped with some combination of insight-therapy, Rational Emotive Behavior Therapy, hypnosis and other more conventional tools. But with some clients, not all, there comes a time when the emotions within their awareness or that surface through other methods, are not all that is troubling them. Often they are carrying painful emotions below the level of awareness.

When the depth emotions are not sufficiently available to the client's awareness, another valuable tool is nudity. The client is always given the choice of how near to nude they are willing to be. For some, the association of nudity with sexuality is too strong and full nudity might even be counter-productive. (Though, I have discovered that if the client can trust themselves, the concerns disappear very quickly. After a few minutes of tenseness, they begin to relax and discover that nothing terrible is occurring and that they are in charge of themselves and their experience.)

Working with the body can be done by using loose clothing like sweatsuit. Removing all constricting clothing such as belt or bra for women or tight shorts for men and then covering up with a sweatsuit is an option. While it still leaves the body armored, at least it is more lightly armored and the client is better able to focus attention on the internal sensations of their body.

This work is almost always done with the client lying supine on a massage table. We often, in session, talk about "table work" as a short-hand, as in "the emotions that arose during table work."

Some clients are never able to work nude. It is always the client's choice, as are all the the techniques I use. With some clients who have found themselves able to trust both me and themselves, fully removing their clothing is like taking off the armor. I try to help them become comfortable with exposing their own emotions by exposing their bodies, not so much to me as to themselves.

To this end, I help them lie back without the emotional armor and become aware of the tenseness and stress within. We usually begin with some focused breathing. Many clients come to me not knowing how to breathe deeply. So we begin with learning that skill. Focus on expanding the belly, contracting the diaphragm and getting as much air as possible.

When the person is able to be clearly aware of the air moving in the body, we proceed to use that air to fill other parts of the body. Clearly, this is not a literal possibility; human anatomy does not allow it. However by using our imagination, we can "push" some of the air into the shoulders, the pelvis, into the thighs, into the legs, etc. This helps the person become aware of the tensions in various parts of the body.

At some point in all of this, the person begins to be in touch with emotions that have been outside of awareness. While they were affecting his or her life, they were hidden beneath the surface. It is not so important to know where or when those emotions first arose, but to recognize them and know that they are controlling the person here and now. This point may come early with the breathing, but more often it takes some time.

Depending on the person, and maybe in additional sessions, we can go further and identify those emotions more fully. There is a gradual transition in most nude sessions when the client's emotional energy has been expended and they feel more peaceful. This is when we conclude that session. Usually, I leave the area and let the person just rest until they feel able and ready to get up and dress themselves.

Since our goal, in most counseling encounters, is for the client to leave our sessions more "in charge" of themselves, becoming aware and able to enjoy emotional health, we do not stop here. It is important to immediately get the clothed client talking about the experience and acknowledging the emotions which arose in the table work. While we may not have time in a normal session to fully use the information in cognitive process, we do mark it for future effort and ensure that it is fixed in the client's mind. The client is sent away with some homework, to practice some of what we did for themselves; at least, to practice the breathing exercises. Of course, a client who has mastered the skill of REBT exercises will be encouraged to use the emotional information that way.

We follow up in the next session by working with various tools to process the emotions more fully. Due to the depth of what comes to the fore, it is unusual to use nudity two sessions in a row. The power of the nude work provides so much growth material that it normally takes a full process session or even more between. On rare occasions, and especially at the client's request, we may do table work more frequently.

Because I want to ensure that the client understands the non-sexual nature of this nude table work, I am careful to use exam gloves. It is a way of emphasizing that there is no sexuality involved in any nude touch. Of course, I am a "huggy" person and am not adverse to touching a clothed client if it is appropriate, but it is important that nothing we do in session is mistaken as sexual. This is especially true with clients from Latin American backgrounds. They are much more likely to be touch friendly. Many of the cultures are sexually conservative but they still tend to great each other with a hug.

Like all my blog entries, I wrote this for myself. However, if you find it useful I am delighted.