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The evolution of autogenic psychotherapy in Spain.

Autor/autores: Luis de Rivera
Fecha Publicación: 21/12/2012
Área temática: .
Tipo de trabajo: 

RESUMEN

It is difficult to understand the development of autogenic training in Spain without realizing how devastated Spanish Psychiatry was after the Civil War. Most of its prominent practitioners were forced into exile. Mira-Lopez, the inventor of the myokinetic test, went to England. Angel Garma went to Argentina, where he soon became the president of Buenos Aires Psychoanalytic Association. Miguel Prados went to Canada, were he co-founded McGill University Psychiatry Department. Tosquelles went to France, were he was soon the director of a most progresist psychiatric hospital. De Ajuriaguerra became University Professor and the Chairman of Genève?s celebrated Psychiatric Services... Spanish Psychiatry became stagnant for decades, but Spain?s loss became the World?s gain. When Schultz?s Autogenes Training was first translated into Spanish in 1954 (1), there were few high ranking professionals available to take the lead.

Palabras clave: autogenic psychotherapy.

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http://hdl.handle.net/10401/5951

Avances en Salud Mental Relacional
Advances in Relational Mental Health
ISSN 1579-3516 - Vol. 11 - Núm. 2 - Julio 2012
Órgano de expresión de la Fundación OMIE y AMSA Avances Médicos
Revista Internacional On-line / An Internacional On-line Journal

THE EVOLUTION OF AUTOGENIC PSYCHOTHERAPY IN SPAIN

Luis de Rivera
(MD, FRCPC, Professor of Psychiatry)
www.psicoter.es

SUMMARY
It is difficult to understand the development of autogenic training in Spain without realizing how
devastated Spanish Psychiatry was after the Civil War. Most of its prominent practitioners were
forced into exile. Mira-Lopez, the inventor of the myokinetic test, went to England. Angel Garma
went to Argentina, where he soon became the president of Buenos Aires Psychoanalytic Association.
Miguel Prados went to Canada, were he co-founded McGill University Psychiatry Department.
Tosquelles went to France, were he was soon the director of a most progresist psychiatric hospital.
De Ajuriaguerra became University Professor and the Chairman of Genève's celebrated Psychiatric
Services... Spanish Psychiatry became stagnant for decades, but Spain's loss became the World's
gain. When Schultz's Autogenes Training was first translated into Spanish in 1954 (1), there were few
high ranking professionals available to take the lead.
Key words: Autogenic psychotherapy.

© 2012 CORE Academic, Instituto de Psicoterapia

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An exception was Ramón Sarro, who in 1958 organized an International Psychotherapy
Congress in Barcelona, attended by Schultz himself. Soon, autogenic training was of notice to medical
specialists, such as the internist Rof-Carballo, the pioneer of Psychosomatic Medicine in Spain, and
the gynecologist Aguirre de Carcer, a pioneer of natural childbirth. Meanwhile, Lopez-Ibor, a brilliant
clinician and a fierce opponent of psychoanalysis, opened his Chair in Madrid University to a young
Colombian neuropsychiatrist, Alfonso Caycedo, who in October 1960 founded the first Department
of Clinical Sophrology in the Madrid Provincial Hospital. Little is known of Caycedo´s teachers and
training, but his method constitutes an interesting amalgamation of autogenic training with
hypnotism, yoga and a few original contributions. Like Emile Coué´s autosuggestion method in the
XIX century ("Every day, in every way, I'm getting better and better"), Caycedo´s "Dynamic
Relaxation" took its surroundings by storm, spreading soon to Catalonia, France and, of course,
South America. Like Coue´s, its fame was short-lived. However, it left the medical and psychological
professions with the misleading perception that autogenic training was a soft kind of hypnosis, of
marginal scientific interest and of minor use, at the most, an adjuvant treatment for somatized
anxiety. Lack of proper instructors, excess of amateur practitioners and bold unsubstantiated claims
brought relaxation techniques in general into disrepute, and finally into oblivion.

It was not until the mid-seventies, with the return of young professionals trained abroad,
mainly in North-America and in Switzerland, that autogenic training took a new turn. The Spanish
Society for Autogenic Psychotherapy was founded in 1979; in 1995 changed its name to Spanish
Association of Psychotherapy, but kept in its By-laws the "study, application and development of
autogenic approaches" as one of its aims. Jose Guimon, a disciple of De Ajuriaguerra, founded in
Bilbao the first University Chair of Psychiatry in the Basque Country, where he introduced
"psychotonic reeducation", his teacher´s version of autogenic training. Soon, he invited his long-time
friend and colleague Luis G. de Rivera, a close disciple of Wolfgang Luthe and the member of I.C.A.T.1
representing Spain, to impart regular seminars on autogenic training in the Bilbao Institute of
Psychotherapy. Jose Guimón was also the director of the first Spanish doctoral thesis in Autogenic
Therapy, read in the University of Bilbao, in which the studies by Luis de Rivera on the treatment of
Temporal Lobe epilepsy with autogenic training were reported (2).

1

The International Committee for the Coordination of Clinical Application and Theaching of Autogenic Therapy (ICAT) held
its first meeting in Montreal in 1961 during the third World Congress of Psychiatry.

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Fig. 1. Nomination of ICAT member representing Spain

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In 1986 Luis G. de Rivera became the first Chairman of Psychiatry in the University of La
Laguna in the Canary Islands, where autogenic training began to be regularly taught to medical
students. Several doctoral dissertations were read on different aspects of the method, like Manuel
Henry´s Autogenic Therapy of Bronchial Asthma (3), Garcia-Trujillo´s Subjective Experiences during
the Autogenic State (4), Rodriguez-Abuin´s Stress Reactivity in Temporo-Mandibular Dysfunction (5),
Moron´s Autogenic Psychotherapy and Stress Prevention in Children (6), Salom-Serra´s Introduction
of Auto-relaxation techniques in Medicine (7)...
Over the last decade, several University postgraduate programs in Clinical Psychology and
Psychotherapy have introduced autogenic training in their curriculum. The core of the "Diploma de
Formación Superior en Psicoterapia" (Diploma on High Training in Psychotherapy) offered by the
Universidad Autonoma de Madrid between 2004 and 2011 was built around the autogenic approach.
The current Spanish standard textbook on basic autogenic psychotherapy, sponsored by the UNED
and the Spanish Association of Psychotherapy, evolved from the lectures imparted since 1997 in the
Master "Psychopatology and Health" organized by the UNED (8,9). Likewise, Autogenic
Psychotherapy is regularly present at Spanish Scientific Meetings. International Congresses
celebrated in Madrid, such as the X Congress of the International College of Psychosomatic Medicine
(10) and the X World Congress of Psychiatry (11) both of which included symposia on Autogenic
Psychotherapy, attended by distinguished speakers such as Gastaldo, Wallnofer, Ikemi, Carruthers,
Diamond, Pszywyj, Stetter and others.

Besides clinical research on epilepsy (12, 13), anxiety (14,15, 16), stress (17, 18 19) and
psychosomatic disorders (20, 21, 22, 23), there has been a considerable effort in the extraclinical
applications of autogenic training, such as in psycho-pedagogy, in the mobilization of creativity and
in the increase of resilience (24, 25, 26, 27, 28, 29). The recognition that the central brain
mechanisms activated by the standard autogenic exercises are the same involved in the altered
consciousness states induced by oriental meditation techniques prompted comparison studies with
these techniques (26, 27, 28, 29, 30, 31). The application of our States of Consciousness
Questionnaire (32) is helping to position the autogenic state in the general map of Consciousness
States.

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Fig. 2. Map of States of Conciousness

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Autogenic training seems to be the safest and most clinically rewarding of all the meditation
techniques studied. It is difficult to ascertain if some severe side effects of oriental techniques are
related to the technique itself or to awkward use by questionable gurus, but we have described two
cases of psychosis precipitated by the practices of a mystical oriental group (33). Likewise, we have
detected surprising training difficulties with some trainees coming from yoga schools, who have to
unlearn improper approaches to passive acceptance in general, and to respiration control in
particular. Of course, it may be argued that it is unfair to compare the results of autogenic
psychotherapy, which in Spain is a medical and clinical-psychological procedure, with those of the
oriental meditation schools, whose aim is enlightenment or some other mystical achievement. This is
true, albeit some practitioner may claim that autogenic psychotherapy, especially when the most
advanced methods are applied, is a safe vehicle to self-discovery and transcendence. Nevertheless,
for the most part, autogenic psychotherapy is taught and practiced as a clinical procedure.

The term Autogenic Psychotherapy was introduced very early in Spain to cover both basic
autogenic training and the most sophisticated advanced techniques (34). This was not a mere
terminological preference, but the recognition that the Autogenic Approach contains all the
elements of a full-fledged psychotherapeutic procedure. Conceptual comparative studies with
psychoanalysis (35,36) and with behavioral-cognitive therapy (37) revealed many coincidences. The
flexibility and comprehensiveness of Autogenic Psychotherapy enables its practitioner to integrate
other approaches, without damage to its own core. Based both on clinical practice and on
fundamental principles of human functioning, Autogenic Psychotherapy is an example of integrative
psychotherapy, open to growth by apposition of progressive developments.

Psychic education is an important part of the Spanish way of practicing autogenic
psychotherapy. "Asking an anxious person to relax is cruelty, unless you teach him how" is one of our
best known mottos. The general philosophy is that the trainee-patient is doing his/her own therapy,
and the therapist is merely transmitting the know-how and supervising its application. Other
important skills acquired by the trainee-patient are self observing acceptance ­ which implies
learning to differentiate between brain-directed processes and self-directed processes-, and free
association, which implies the full application of the principle of non-interference to brain directed
processes.

As it is taught in Spain, basic autogenic training is maintained in its most pure form, following
Schultz technique as transmitted by Luthe (38). Our particular care on teaching basic concepts is
justified by the frequent confusion of Autogenic Training with hypnosis and with peripheral
relaxation techniques (39). Passive concentration on interoceptive perceptions is not akin to the
hypnotic induction of bodily sensations. The trainee is aware of a sensation that is really present, not
fabricating in his imagination this or that subjective experience. In our view, Basic Autogenic Training
is a central relaxation technique, closer to meditation than to auto-suggestion or to physical
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relaxation. The six standard exercises are usually preceded by a preparatory exercise, sometimes
called the "cero standard exercise", consisting in just sitting without doing anything. "Doing nothing"
is quite difficult for some people, but it allows the trainee a firsthand experience of himself. It is the
incidental way of learning the difference between automatic body-mind processes and what one
does (more or less) on purpose. Automatic processes happen by themselves, they are "brain
directed", in Luthe´s terminology, and they are to be accepted without neither interference nor
complacency. This experience affords a practical introduction to "passive acceptance", an ability that
seldom, if ever, can be transmitted by books or lectures, by only by the guidance of a personal
teacher. As its related companion, Passive Concentration, both are sophisticated techniques, such as
ice-skating: Impossible to perform if one does not know how to do it, difficult when the trick is first
learned, and as easy as walking, once the process has been mastered through proper practice.

Fig 3. Methods of Autogenic Psychotherapy

The development of the advanced autogenic methods in Spain follows closely Luthe´s teachings
(40). He attributed the therapeutic action of autogenic training to an increase of the self regulatory
capacities of the organism, operating through functional modifications in the central nervous system.
For a long time it was noted that patients developed transient "training symptoms" during passive
concentration on the autogenic formulae, but it was not until 1961 that Luthe elaborated on the specific
therapeutic value of these "autogenic discharges" (41) . According to him, autogenic discharges, defined
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as "short-lived motor, sensory or psychic manifestations which spontaneously and paroxisticaly
appeared during the autogenic state", are the expression of homeostatic adjustment reactions, aimed to
the elimination of pathogenic neuronal excitation corresponding to memory engrams of traumatic
events- both psychological and physical. In extensive studies, Luthe was able to show a clear correlation
between the amount, type and intensity of autogenic discharges and the complaints, the traumatic
history and the clinical course. In order to apply to full clinical advantage this phenomenon, he
developed the neutralization techniques, which culminated in the autogenic abreaction method. Thus,
he introduced a way of dealing with training symptoms, preventing troublesome discharges to threaten
the continuity of treatment, and, at the same time, discovered a most effective therapeutic method.
It is of interest to mention that, through the clinical practice of autogenic abreaction, it became clear the
damaging psychological effects of physical accidents and invasive medical procedures, particularly when
combined with alteration or loss of consciousness (sedation or general anesthesia). Minimal neurological
lesions cannot be easily detected nor treated by the usual methods, but autogenic psychotherapy may
revert such disruptive psychophysiological after-effects. It is to the credit of Luthe expanding the
indications of autogenic methods beyond the psychological disorders, and, on the other hand,
discovering the psychopathogenetic effects of physical injuries.

Autogenic Analysis is a combined modification of both Autogenic Abreaction and Freud´s
early cathartic method (42). Like in Autogenic Abreaction, the therapist refrains from interpreting the
contents of the discourse, while promoting the continuity of the process. Like in psychoanalysis, freeassociation is the main technical tool. Passive attention and non-interference to the flow of evolving
feelings is an original aspect of autogenic analysis, which complements the description of visual and
somatic discharges characteristic of autogenic abreaction. Spanish attempts on bridging autogenic
training with psychoanalysis started in 1972, and were first presented in the III World Congress of
Psychosomatic Medicine (Roma, Sept. l975), By the year 2000 the autogenic state was recognized as
the "royal road to the unconscious" and passive acceptance as the real way of learning to freeassociate. Autogenic Analysis was officially presented in the 43 rd. Winter Meeting of the American
Academy of Psychoanalysis in NewYork. Luthe´s Autogenic Abreaction is still been practiced in its
pure form in Spain, as a most accepted method. Other psychoanalytically oriented autogenic
approaches, such as Wallnöfer´s Analytic Advanced Autogenic Training (43, 44), and Ranty´s
Progressive Autogenic Training (45) are increasingly known and practiced. While close to
psychoanalysis, the new method of Autogenic Analysis fully respects the basic autogenic principle of
non-interference, which includes refraining from interpretations while the patient is in the autogenic
state. Autogenic Analysis follows a psycho-educative approach, teaching the patient to: 1. Induce the
autogenic state, 2. Maintain a passive-acceptance observing attitude, that is, differentiating between
"brain directed" phenomena and "patient directed" phenomena and 3. "Free associate", that is,
describing the brain directed phenomena which manifest themselves in the autogenic state, without
allowing interference by patient-directed processes. This psycho-educative attitude would have been
a major improvement to Psychoanalysis, which expects the patient to discover all by himself how to
calm down, how to free-associate and how to integrate his unconscious processes. We agree that
self-discovery and growth is a highly personal task, and that the therapist cannot tell the patient
what to do with his life and what his best choices are. But it makes good therapeutic sense to teach
him the tools and procedures that can assist him on his work of self discovery and growth. The

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principle of non-interference applies to the contents of the unconscious, but the way of getting and
dealing with those contents is a technique that can be taught and perfected.
At present, the Spanish school of Autogenic Psychotherapy has achieved international
recognition, with active participation of its members in relevant events organized by other societies
(46). Entries by Spanish authors are included in the Wörterbuch der Psychotherapie, the influential
Psychotherapy Dictionary edited by Pritz and published by Springer Verlag. Our Level One Official
Course in Ten Weeks has been adopted by ICAT as the basic standard for training in Autogenic
Psychotherapy.

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