Philip Carr-Gomm, Psychologist

Published in JHH 18.2-Frontiers of self-care

About six years ago I decided to take a retreat at a French monastery. It was there that, quite by chance, I was able to spend time with two people who were trained as sophrologists. I had been working for about 25 years with groups using guided imagery and meditation, and with individuals, using ‘talking therapy’, mainly psychosynthesis, and I was starting to feel that I wanted to include the body more in this work, but wasn’t sure where to turn. As I learnt about sophrology from these two new acquaintances, I sensed that this could offer what I needed. Sophrology is a system that places body awareness at the heart of its therapeutic approach, combining this awareness with work on posture, movement, breathing and visualisation.

It’s curious, but sophrology is a modality that has achieved widespread popularity in the French-speaking world and yet it has taken decades to make its way across the Channel, and even now very few people have even heard of it. In France, almost everyone knows what a sophrologist is and does. In Britain, virtually no one.

History

Sophrology was developed by a Colombian doctor, Alfonso Caycedo, who as a novice psychiatrist working in Madrid became concerned with the effectiveness of conventional treatments for distress – insulin and electroshock therapy, drugs and ‘talking therapies’. What struck him as absurd was the way he was being asked to affect patients’ consciousness, despite the fact that psychiatric training involved no study of the phenomenon of consciousness itself. Caycedo’s mentor was Ludwig Binswanger, a colleague of Sigmund Freud, who was passionate about the study of consciousness and had founded the school of phenomenological psychiatry. This approach to the human mind focuses on subjective experience, and lies at the root of the more well-known person-centred and humanistic psychotherapies. In 1965, Binswanger encouraged the young psychiatrist to go to India, where the study of consciousness was already centuries old, and so Caycedo and his wife spent the next two years travelling in India and Japan, studying yoga and meditation, visiting ashrams and meeting with spiritual
teachers, yogis and the Dalai Lama.

Synthesis

On their return to Europe, Caycedo incorporated ideas and techniques from all that he had learned into an approach to healing and personal growth that he had started to develop before he had left for India, and in 1960 had named ‘sophrology’ – from the Greek, meaning ‘the study of harmonious consciousness’. With its beginnings in his researches into relaxation therapies, hypnotism and phenomenology, Caycedo was now able to introduce ideas from yoga, Tibetan Buddhism and Zen. He somehow managed to synthesise all that he had discovered into a simple and effective form of training that could be used either for healing, or for personal and spiritual development. Instead of all the different influences he had explored combining in a haphazard way, Caycedo took the core ideas and techniques from each of these to create a profound and elegant system that proved so effective that soon hundreds of psychiatrists, doctors and dentists were using sophrology with their patients, and over the following five decades his system grew to occupy a unique place in the French-speaking world.

On the one hand, Caycedo’s system of sophrology was used in conventional clinical settings: dentists used it to calm anxious patients, psychiatrists used it to heal without the use of drugs or shock therapy, doctors applied it to the relief of chronic pain and fatigue. But at the same time, lay practitioners and psychologists found it helpful in all sorts of ways, including relief from stress and phobias, and in the teaching of relaxation and meditation.

It was the application of sophrology techniques to improve sports performances that catapulted sophrology into the general public’s awareness in 1968, when the press publicised the way Swiss athletes were getting more Olympic medals by being taught its methods to increase their ability to focus and reduce stress. The success and popularity of sophrology in sports coaching led the way for the development of training institutes and the application of sophrology in many fields, including education and management, and it stimulated the development of sophrology within its initial area of interest, medicine: to help improve physical and mental health.

Confined to France?

Over the years, sophrology has gone through the seemingly inevitable phases of schisming and diffusion into different schools: there are ‘classical’ approaches that stick to the original formulations, schools that combine techniques with other modalities such as psychoanalysis; medical professionals who make use of certain techniques; lay practitioners who combine methods with alternative therapy approaches. It’s a rich and varied ecology with monthly magazines, annual conferences, dozens of institutes offering training, and thousands of practitioners offering their services. Nowadays, you can find a sophrologist in virtually every town in France, so the mystery is why it has remained such a French phenomenon. It has never really taken off anywhere else, not even in Caycedo’s Spanish-speaking world.

I haven’t come across any discussions about why it hasn’t successfully broken out of the Francophone world, but I suspect sophrology is its own worst enemy – articulating its theory and its roots in phenomenology in an over-intellectualised way that includes creating its own vocabulary of so many neologisms that its critics accused it of being deliberately obscure. Despite these hurdles, some brave souls are trying to teach sophrology in a more accessible way in the English language. Once I experienced some of its exercises, and got a sense of what was going on, I realised what potential lay in working with this modality.

Starting with this initial curiosity that got me training in it, I was fully hooked when I used it to fix a minor issue that was nevertheless troubling. In a training session to try out a certain technique, we were asked to choose a problem that bothered us. I was feeling particularly buoyant that day and couldn’t locate anything wrong to work with, but then remembered that I had a phobia about swimming out of my depth. Not a big deal, I thought, but I used the 15-minute technique suggested, only to discover a new passion in my life: swimming whenever I can. A small but significant change to my quality of life. If I could free myself of a phobia in 15 minutes this had to be an approach worth learning!

How does it work?

There are specific exercises which address specific problems, which a sophrologist will prescribe for you, explaining how each one works, how to enact it, and then taking you through the exercise, often inviting you to record the instructions on your mobile phone, so you can repeat the exercise easily in the coming days. In addition to these specific exercises, designed to address issues such as anxiety, insomnia, burn-out, or chronic pain, sophrology also offers a sequenced programme of training designed to improve your physical and mental wellbeing, and this can be followed whether or not you are also working on a specific problem. In both cases, the exercises make use of the same techniques: gentle stretching, awareness of posture and movement, diaphragmatic breathing,
visualisation, and the use of positive statements to engender a sense of hope and meaning.

Reminiscent of elements of Alexander technique, autogenic training, yoga, mindfulness and neuro-linguistic programming (NLP), yet unique, flowing and elegantly simple, the theory underpinning the exercises will be familiar: so many problems, both mental and physical, are caused by stress and tension. When we teach a client how to relax deeply, and use their body awareness and cognitive abilities we start making change possible. In doing this, we are working with the power of somatisation, the ability of the mind to influence the body positively and potentially to improve mental and physical health, and quite possibly harnessing the brain’s neuroplasticity to actually re-wire the nervous system.

Experiential learning

At this point, if you and I were in conversation, or in a training session, it would make sense to actually do an exercise, so you could get a feel for it. If you’ve got 10 minutes or so, you could scoot over to www.sophrology.institute and go to the page ‘The Book’. There you’ll find 26 audios and you could try one out – say exercise 18 or 20 – which are good examples of a typical sophrology exercise.

Imagine doing exercises like that for 10 minutes or so a day. You might be directed into the past towards memories, or into the future to engender hope and offer opportunities for rehearsal (you can imagine how this is used in sports coaching). You might be directed towards focusing your attention on different parts of the body, or on different cognitive functions.

All this is different and more varied than the practice of mindfulness, but it makes use of the same mechanisms of directed awareness, and attention to breath and the sensation and representation of the body in consciousness. But here’s a crucial difference – it’s easier than mindfulness. You are less likely to find your mind drifting, because you’re kept busy, being told to stand up, sit down, move your arms, hold your breath, and so on.

Where is the research?

When Kabat-Zinn introduced mindfulness into clinical settings he began a tradition of research that now, decades later, means there is a solid body of evidence to support the value of using the method on its own, and in conjunction with other modalities such as cognitive behavioural therapy (CBT). And although sophrology is about 20 years older than Kabat-Zinn’s mindfulness protocols, because it grew out of a phenomenological approach which places the emphasis on subjective experience, far less research has been done into its therapeutic benefits. This lack of a substantial evidence base is undoubtedly a handicap, and may limit sophrology’s ability to be used in social prescribing. Sophrologists in the UK are currently exploring how this might be achieved, as there is a slowly growing body of evidence emerging out of Europe that supports the effectiveness of sophrology in treating certain conditions.

Nevertheless let’s look at two recent studies: one on the use of sophrology in treating subjective tinnitus, and one on its use in reducing the symptoms of anxiety and depression. In the first study, carried out in France in 2020, 140 consecutive patients, aged 18–83 had 6–8 sessions of sophrology over 2–4 months. Post-treatment progression on the Tinnitus Handicap Inventory scores was better than 20 points in 59.2% of cases, which was clinically significant and independent of tinnitus duration and cause (Grevin P et al, 2020).

A second study from the Department of Psychiatry and Forensic Medicine in Barcelona looked at the effectiveness of sophrology in of anxiety and depression. This involved 70 primary care patients reporting moderate to high anxiety levels randomly allocated to either a group that followed a sophrology programme, or  to the control group that followed a cognitive programme based on physical and mental health recommendations.

The sophrology group showed statistically significant improvements in all Hospital Anxiety and Depression Scale (HADS) and State-trait Anxiety Inventory (STAI) Subscales regardless of gender or age. The pre-post effect sizes for anxiety and depression symptoms were large for sophrology and small to moderate for the control (van Rangelrooij et al, 2020).

The results from both these studies are encouraging, but more research is needed, and I really hope that more sophrologists will come to understand the value in creating a strong evidence base. If you are interested in finding out more and you read French, there is a wealth of material online and in the literature. If it needs to be in English, then some starting points would be the Sophrology Institute https://sophrology.institute/ and the Sophrology Network https://thesophrologynetwork.com/

Further reading

Empower your life with sophrology: quick and simple exercises to reduce stress, boost self-esteem, and help you find joy. Philip Carr- Gomm, CICO Books, 2019.

The life-changing power of sophrology: breathe and connect with the calm and happy you. Dominique Antiglio, Yellow Kite, 2018.

The sophrology method: Simple techniques for a calmer, happier, healthier you. Florence Parot, Gaia Books, 2019.