The Triangle We Cannot Escape—Until We Can

There’s a pattern that repeats itself endlessly in human relationships, one that Felitti and De Zulueta (1988) articulated with devastating clarity in their work on the trauma triangle. We cycle through three positions: Victim, Persecutor, and Bystander—the one who observes suffering but does nothing to intervene, who stands by while harm unfolds.

If we lived these dynamics as children—and most of us did, in various forms and intensities—we don’t just remember them. We internalize the entire triangle. It becomes the water we swim in, the air we breathe, the automatic choreography of our relationships. We oscillate between positions, often without awareness, recreating the very patterns that wounded us.

Here’s the cruel paradox: The child who was victimized grows up and, in certain contexts, becomes the persecutor. The adult who was persecuted can, in the very same moment, persecute another. The person who once stood by helplessly may now stand by as others suffer, caught in the same paralysis that allowed their own suffering to continue.

The triangle doesn’t end when childhood ends. It lives in us, playing out across our adult relationships, our professional work, our intimate connections. Until we find a way out.

That way out is what I call the fourth position.

The Continuum We Refuse to Discuss: Pleasure, Meaning, and What Is Missing in Psychotherapy and Medicine. When Did Doctors and Psychotherapists Forget About Joy?

Imagine entering a therapy session carrying not a problem, but a moment of genuine happiness. Imagine your therapist or doctor waiting — pen in hand — for the difficulty to arrive.

For many patients and doctors, this is precisely what happens. And for many therapists and physicians, however good their intentions, the training, theoretical frameworks, and even the language of their work orient them almost entirely towards suffering. Pathology. Wound. Deficit. What is broken, and how to mend it.

But what if repair is only half the story?

Picture this: Your client has just told you something—once, twice, now a third time. The words are slightly different each iteration, but the essential message remains the same. By the seventh repetition, you might feel frustration creeping in. "I heard you," you want to say. "Why do you keep saying this?"

But here's what I've learned in decades of practice: When our clients repeat themselves, they're not being difficult. They're signaling something crucial—something we haven't yet heard, or something they haven't yet managed to say.

Have you ever experienced a moment of pure happiness, only to immediately feel a wave of anxiety wash over you? Perhaps you've caught yourself thinking, "This is too good to be true" or "Something bad must be coming." If so, you're not alone. This phenomenon, which we might call pleasure anxiety, is far more common than most people realize.

Pleasure anxiety is the paradoxical experience of feeling anxious precisely when things are going well. It's that nagging voice that whispers we don't deserve happiness, or that good fortune must inevitably be followed by disaster. This isn't just pessimism—it's a deeply ingrained psychological pattern that can prevent us from fully experiencing joy in our lives.

In memory and gratitude to Clover Southwell, an accomplished biodynamic psychotherapist, supervisor, teacher, author on the biodynamic work, and a friend.

She worked globally: at major UK schools (Gerda Boyesen Centre, London School for Biodynamic Psychotherapy, Chiron centre, etc.), across Europe (France, Germany and Austria), in Brazil, the USA, and Japan — illustrating the attunement, energy flow, and systematic dimensions of the biodynamic approach more than any other. Her organised teachings and writings uniquely integrate biodynamic theory and practice.

I propose that there are fundamental limitations to current scientific mainstream methods of writing about therapeutic processes that in fact hinder our ability to both write about our therapeutic process and to learn from other clinicians' and researchers' writings.

In my view, these limitations may partially be compensated for by allowing creative writing, poetry and other forms of art to be the major part of a case study, where the objective measures must be integrated into the subjective frame of writing. Creative writing conveys its truth by acknowledging the intense subjective complexity originating from sensations and emotions accompanying the actual objective memory. Therefore, describing only the client and therapist's narrative itself or material that is only observable by external senses, heavily compromises the quality of the therapeutic process.

From an object-subject relationship point of view, we should never underestimate how challenging it might be for a body-mind system that has been betrayed by humans to trust humans again—to trust the object ‘human’ and to authentically experience that this subject is safe. It is especially important to explore the complexity of touch and the right touch for people who have undergone traumas of physical, sexual or emotional abuse in their family, when, in fact, inside the family somebody manipulates their most basic attachment needs, where love was demonstrated manipulatively in order to abuse the child as an object for the fulfillment of the perverse fantasies of the adult who was supposed to protect him.

Biodynamic massage (Southwell, 1982) is an integral part of biodynamic psychotherapy (Boyesen 1980, 1981, 2001; Heller 2012; Lewin & Gablier, 2013; Southwell, Selles, Tanguay, & Steinberg, 2014; Southwell, 1998), which allows psychotherapeutic work within the framework of the body. The name ‘biodynamic massage’ encompasses fourteen different methods of touch. Almost all the touch methods can be performed at different levels of the body - the level of bones, the periosteum, the deep and superficial muscles, the fascia, which contain the muscles, the subcutaneous tissues, and the different levels of energy.

A biodynamic psychotherapist is often guided by a stethoscope (either electronic or ordinary) whilst carrying out biodynamic massage (Southwell, unpublished; Stauffer, 2005, unpublished, 2010; van Heel, 2014); the stethoscope is utilized for listening to the digestive system’s sounds (also known in this context as the psycho-peristalsis) (Boyesen, M-L. & Boyesen, G. 1978). This makes it possible to obtain immediate feedback from the body about the level of accuracy, quality, and attunement of the touch applied. The experience of touch must be modulated by context and internal state (Ellingsen et al., 2016).

Every particular landscape of events in the therapy room and events that are surrounding this time, act as a microcosm of the universe of the intersubjectivity of the two people in the room. The web of phenomena can be described as multi parallel levels and patterns of balance and flux that we can relate to as phenomenological research.

As much as we, as therapists, can have a fuller understanding of more parallel processes we can be more effective. When biodynamic psychotherapists use Vegetotherapy and Biodynamic massage, they are essentially working in the first two modes of relationality (non-verbal modes) in the interpersonal field to enable dynamic self-regulative processes, which facilitates organic "emergent properties and motives" (Mitchell, 2000, p 57), not only as a mental representation but also concurrently with bodily manifestations.

Bodily manifestations can for example be seen in the case with which I began my first blog on (date). However, just using the 'movie' of the occurrences, elaborating on the detailed visceralised story of the client, can enable us to start getting a fuller perspective on the multilevel intersubjective and intersubjective processes occurring within the client.

I think of biodynamic massage as learning a new kind of dance: one where my hands, attention and the client’s body all move together in a partially conscious rhythm that nudges deep, subcortical processes toward health. As clients relearn how to “dance” with themselves—self-regulating, feeling their bodies, finding direction amid constant change—the inner life-force begins to move again, and life starts to feel worth living. In this web of dynamic phenomena, my role is to support spontaneous synchronization of energy and information, so that the body’s own intelligent regulatory systems can keep evolving toward salutogenesis, not just away from pathology.

I watch a mother and baby play, and what I see looks less like caregiving and more like a dance: touch, gaze, rhythm, tone, all weaving a felt message of “You belong here, and life is worth living.” In my biodynamic work, I try to recreate that kind of good enough touch—subtle, non-verbal communication that reaches beneath words into the autonomic nervous system and early templates of safety. By becoming more aware of these subcortical processes, I can offer clients a corrective experience where body and mind are tended together, helping them re-learn how to “dance” with others and with themselves, moment by moment.

I step into the therapy room and my attention goes first to the body in front of me: the curled shoulders, the over-extended arms, the subtle ways someone seems to hold themselves together. I don’t rush to diagnose or name these patterns; instead, I treat them as clues in a living, shifting puzzle—a web of phenomena that invites my curiosity. With biodynamic methods and a non-judgmental atmosphere, I track how posture, sensation and feeling change moment by moment, and I trust direct, embodied experience more than theory. This is what makes biodynamic massage psychotherapeutic: it helps clients discover their own truth from the inside out.

I pick up my stethoscope and place it gently on a client’s abdomen, listening not just for digestion but for psychoperistalsis—the body’s own commentary on my touch. As the sounds rise and fall, they guide my hands as much as the client’s words do, attuning me to the parasympathetic nervous system, vagal tone and the subtle shifts in posture, breath, muscle and skin. Over time I’ve learned that biodynamic massage isn’t just about technique; it’s about meeting a living, changing body-mind in real time, dropping rigid theory and staying present to what emerges between us. My role is not to rescue, but to support the client’s innate capacity for self-organization and healing, one responsive touch and listening moment at a time.

I walk into my therapy room—dark aubergine, purple, pinkish lilac—and notice how my clients inhabit it long before they notice its colour. One day, a client suddenly sees that the walls are pink, and that small shift in perception stops me in my tracks. What has changed in her inner world that allows pink to exist now, alongside pain and intrusive thoughts? As I listen to her, and later to a musician-client who begins to hear an entire symphony rather than just his own part, I start to trust these sensory awakenings as signs of deep, organic change. This is how psychotherapy, especially biodynamic work, quietly reshapes our capacity to feel and perceive.

Psychotherapy is defined as a mental or emotional therapeutic process engaged in by people who suffered crises or distress which presented as mental. But body psychotherapy’s fundamental assumption is that every mental process presents both mentally and in a physical manifestation, which cannot really be separated, unless for the needs of discourse and after-the-fact discussion. For example, in the case with which I began this blog post, when her mental and emotional realization started to unfold and evolve this was concurrent with the appearance of bodily manifestations. We saw an integrated process of emotions and soma: in her body posture and movements, her breathing pattern, her energetic presence and her resonance with the group, which changed completely. Her process is one integrated collection of phenomena.

I wish to emphasize the relatively straightforward view that accepts a practical mind-body-brain-soul unity, in contrast with any philosophical (or otherwise) view that purposes dichotomy. The practical mind-body-brain-soul unity seeks to melt away conceptual barriers between different disciplines in health care, for the sole purpose of moving forward our understanding of human discomfort, illnesses, joy, pleasure and hope. The main thought in mind here is how to support health and wellbeing.