Making Faces: A Clinical Case

From Volume 55 Number 2

Alberto Foglia, M.D.

This clinical case illustrates the significance of one of the basic tools of medical orgone therapy—work on the patient’s muscular armor— here, in particular, indirect work. The latter, instructing the patient to perform specific movements, fulfills two functions: that of turning off higher cognitive functions and preparing the patient for future emotional expression.

In this case, armored facial muscles held back excruciating memories of trauma from the patient’s childhood. These were therapeutically liberated together with their corresponding emotions.

The Case

Claudia was a lively and intelligent divorced mother, employed as a cashier, who contacted me because of difficulties with her 10-year- old daughter. She told me that her daughter had become unhappy, stubborn and rebellious over the last few months. Prior to this time her daughter was, according to her mother, a happy child with a sunny disposition. Claudia had the sense that her daughter’s present state was not merely “typical” adolescent rebellion but rather pointed to something more significant underneath.

I told Claudia that I only treat children if one or both of the child’s parents are in therapy with me. Without hesitation, Claudia agreed to begin her own treatment. At her first session, when she was on the couch, I instructed her to look around the room with a wide circular movement of her eyes, to make faces, and to breathe fully in and out through her mouth, and then to kick, hit and yell according to how she felt. I explained that this would help her to turn off her conscious thinking which would then allow emotions and sensations to come through to the surface.

It soon became evident that making faces was most difficult for Claudia. As she tried to move her face, it became rigid and expressionless, causing her to look indifferent, even absent. In subsequent sessions I began to consistently point out her facial muscular stiffness and immobility, and her apparently indifferent attitude. With this she began to move her face on her own, which elicited sadness and disgust. With time, up and down movements of her cheeks and forehead, wrinkling up of her nose, and opening her mouth led to intense gagging and retching. This was immediately followed by memories of her grandfather being physically overbearing, as well as verbally abusive toward her grandmother.

For almost twenty sessions this pattern continued until the 42nd session when the gagging and retching became markedly stronger. Claudia began to shout out, “Go away! No, No! I don’t want that!” Things now became clear to Claudia: she remembered, after many years of complete amnesia, that she was sexually abused by her grandfather. Although at this time in therapy Claudia was not yet certain of the details, she knew that she was not the only one. She realized that all females in the family lived this horrible ordeal: Claudia’s mother, aunt, and cousin. Her grandfather abused every woman in the family and everybody, herself included, had very effectively repressed these terrible memories.

Sessions became excruciating for Claudia. She yelled, cried, felt desperate as well as helpless and incapable of showing any reaction to her grandfather. During one session she remembered with horror how her grandfather had once pulled her out from under a desk where she was hiding just to abuse her again. I now saw a desperate 5-year-old girl having to submit to his pedophilic sexual practices, most probably including fellatio, that were completely against her will but which she could not rebel against or even run away from. By expressing all this pain, the “freezing” of Claudia’s face was no longer as intense. However, her becoming distant and absent, symptoms of dissociation, intensified as details of her continued ordeal came into her memory. By pointing out to her this second line of defense, being absent and “in a trance,” Claudia realized that her new boyfriend, abusive, overbearing, and narcissistic just like her grandfather, yelled at her, sometimes sadistically insulted her, and on a few occasions hit her on the face and head leaving red marks that Claudia’s daughter saw. His very presence in their home, even if he was not an active pedophile, disturbed and traumatized Claudia’s daughter, leading to her difficult behavior and Claudia’s request for treatment.

Sessions always proceeded in the same manner: making faces brought to the surface despair, pain and memories of Claudia’s childhood ordeal. Outside, however, Claudia’s life changed. She left her boyfriend and became more assertive and independent. With this, her daughter’s disturbing behaviors subsided. Even so, at Claudia’s request I began to treat the child in her own therapy. She never talked to me about her mother’s boyfriend but was able in sessions to liberate and express substantial rage toward her mother for having divorced her father, whose absence led to the presence of Claudia’s abusive boyfriend.

Of note, discussing her facial armor, Claudia recalled having had Bell’s palsy¹ when she was around six-years-old, with a recurrence when she was eight.

Discussion

This clinical case highlights the role of indirect work on the muscular armor, dissolution of the muscular armor being one of the essential tools of medical orgone therapy (Reich, Baker). Having Claudia make faces, in fact, revealed to her an ordeal that was completely repressed in her memory but which was still very much alive within her. One single, simple therapeutic instruction, to make faces, allowed her entry to the “previously unknown realm of the unconscious.”²

Claudia’s facial rigidity was the somatic correlate of her submissive, passive attitude and behavior, in particular in her adult love life. It is also possible that this somatic facial muscular rigidity might have been at the root of her childhood Bell’s palsy, which started just after the beginning of her sexual abuse at age five. Claudia doesn’t recall how many months or years these episodes of abuse lasted and, hence, the reason for the recurrence of Bell’s palsy at age eight is unknown. However, Bell’s palsy may recur once in about 10% of patients. It remains to be proved that the patient’s facial armor was the actual and direct cause of her childhood Bell’s palsy.

References

Baker, E.F. 1967. Man in the Trap. The Causes of Blocked Sexual Energy. Princeton, NJ: The American College of Orgonomy Press. 2000.

Eviston, J.T. et al. 2015. Bell’s Palsy: Etiology, Clinical Features and Multidisci- plinary Care. Neurol Neurosurg Psychiatry, Vol. 86, pages 1356–1361.

Heller, P. 2021. E.F. Baker Advanced Technical Seminar.

Jones, E. 1953. The Life and Work of Sigmund Freud. New York: Penguin Books. 1987. Reich, W. 1933. Character Analysis. New York: Farrar, Straus and Giroux, 1972.

1. Bell’s palsy is an acute peripheral facial nerve partial or complete paralysis. Its cause is thought to be uncertain but three possibilities are herpes virus, nerve compression, and autoimmunity. Treatment is mostly based on steroids and antiviral drugs, but surgical decompression is also tried (Eviston, pages 1356– 1361). Heller proposed an orgonomic treatment of this condition (Heller).

2. This is how Ernest Jones referred to the “free association” discovered by Freud (Jones, page 214).