TOUCHING IN PSYCHOTHERAPY

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The use of touching the client's body in psychotherapy is controversial. Some experts see touch as a form of non-verbal communication that can have therapeutic potential, while others believe that it is a path to abuse and the risk of traumatizing the client. Indisputable and unconditional from the point of view of one ideological psychotherapeutic perspective, the violation of "boundaries" when using touch may not be so, if you look at it from the standpoint of a different ideological perspective. And even more, from the standpoint of the latter, this may be a typical manifestation of psychotherapeutic practice.

There is a point of view that touch may be permissible and not violate psychotherapeutic ethics if it symbolizes the mother's position, or if the client, for various reasons, is not capable of verbal communication; if it is necessary to convey acceptance and support to an overwhelmed patient; if the situation requires the therapist to strengthen or restore the anxious patient's contact with reality; if touch is a natural and sincere expression of the therapist's feelings towards the patient, and if such an expression of feelings is known to be useful for psychotherapy purposes.

The touch, which symbolizes the mother's position, should also be well monitored by the therapist. Here are some examples. A young man, 28, left his therapist with a woman who, wanting to show his support, hugged him so hard that he felt her breasts. "The chest of a stranger, middle-aged woman," - at the same time, according to the young man, the therapist slightly swayed him, which caused such strong resistance and a desire to free himself that the young man did not just change the psychotherapist, but persistently looked for a psychotherapist for a man who, according to at least there is no breast. " In another case, a man with a disability who sought psychotherapy with a woman therapist was offended by her maternal strokes, as he perceived it as “pity for the disabled person,” while he needed to maintain male self-esteem.

Cases with clients who have been abused in one way or another in childhood, for example, in relation to people who have experienced sexual abuse in childhood (in this case, a number of clients do not have a distinction between love and violence), are especially discussed. Of course, “squeezing” clients, kissing, “playing with hair”, inviting clients to take the therapist in their arms, lie on the couch together, try to look after the therapist (for example, straighten their tie) are unacceptable.

What I am convinced is that you should never use touch as a "trick" (in this case, we are not talking about some types of body-oriented practice). It is not worth resorting to touching when the client, taking a position of helplessness, manipulates the therapist, "begs" to be stroked on the head; when the therapist does not want, and the client asks or demands to be touched; if the client is against being touched, if there is a possibility that the touch will be misinterpreted by the client; if the therapist realizes that he is experiencing aggressive or sexually charged feelings towards the client.

I am convinced that touch in the therapeutic process can be very powerful, both constructive and destructive. The type of touch, the moment of touch, the area of the body that the therapist touches (of course, there are forbidden zones), the duration of the touch, which can cause completely different reactions and lead to different consequences, are important.

The reasons for the abundant amount of touch in psychotherapy can be:

lack of intimacy between the client and the psychotherapist (one can suspect the therapist has a fear of psychological intimacy, which is masked by physical intimacy, as is the case with people who constantly change sexual partners and are not able to establish long-term close relationships);

blurring the boundaries in the perception of oneself and the other in the client and the psychotherapist;

difficulties in interpersonal relationships with a psychotherapist and their compensation at the expense of the client;

the therapist's inability to “touch” the client's soul through conversation, glance, tone, sometimes silence;

codependency in the psychotherapist and the client.

Touch in psychotherapy can be appropriate and therapeutically justified in order to:

- explore the features of the client's contact and help him “appropriate” new ways of communication;

- provide support (for example, in the form of an offered hand) in external reality, so that the client does not "get lost" in internal chaotic experiences;

- to teach body awareness (for example, awareness of tensions in different areas of the body and awareness of the impossibility, for example, "take", "give", "stop", "insist", etc.);

- to gain access to deep experiences (especially if these experiences are associated with pre-verbal or repressed experience, experience "living" in certain areas of the body);

- to teach a better sense of personal space and personal boundaries;

- inform the client that he is accepted and understood.

- provoke / facilitate physical release (for example, the client is encouraged to use the therapist's body for dynamic resistance);

- provide support, ensure safety.

I was once taught this way: "The therapist's hand should be warm and not carry sexual impulses." I think that when the therapist is aware of himself in the therapeutic process, is able to separate his personal needs from the needs of the therapeutic situation and the needs of the client (not always the need expressed, but the need for self-actualization, which for various reasons was blocked), touch is not capable of traumatizing, and on the contrary, it carries a powerful healing power. The touch cannot be used "blindly", because the therapist has nothing to say, or he does not know how he himself will cope with the pain that engulfs the client, ie. when the therapist acts not out of concern for the client, and not for the future, but out of fear, grabs the touch as a straw, which should save from confusion and fear.

Sometimes we have to be "kind of" cruel when we refuse to embrace the client, and instead of satisfying such a natural human need, we ask the question: "What is behind this desire?" It seems that these words belong to Winnicott: "There will be no completion until we reach the very bottom of the depression, until that which constitutes the subject of fear has been experienced." Sometimes a hand hastily extended to a client can provoke the loss of a key factor in the trauma and block her experience, that is, it can be a step away from what happened, rather than experiencing it. Sometimes the therapist has to be very persistent in order not to succumb to the persuasion of "hug me" or "give me your hand", so as not to turn into a fake "good mother" "mother for fun." In this way, a real relationship can be established between therapist and client in which the therapist remains in her role rather than playing a role projected onto him by the client's distorted perceptions.

The touch in psychotherapy must be adequate to the needs of that client at that moment, taking into account the various psychic dynamics. Along with the fact that the therapist sometimes has to take a consistent and rigid position in relation to touching, an absolutely “sterile” approach in this matter is not acceptable. Cleanliness and sterility are different concepts. Purity is unblemishedness, the absence of extraneous elements in anything, sterility is sterility, the destruction of all living things.

Psychotherapy is not "hugs" (an expression used by one of my clients), "you are my dear", "come on, come on," "hello, bye" and other liberties that are not so rare. Unfortunately, “touch-hungry” people, prone to addiction and who do not have a healthy regulator of proximity / distance with other people within themselves, can fall into the sticky trap of such a specialist, becoming his emotional and material feeding trough.

Touching another should be accompanied by maximum respect, equality, unconditional acceptance of the value of the other person.

The touch must be "congruent" to the degree of intimacy of the therapeutic relationship: the therapist must be aware that the degree of physical intimacy does not exceed the degree of human intimacy.

I think it's right to ask the client for permission to touch every time, it helps the client to maintain control over the situation.

It is easy for me to touch my clients, most often it is a light touch on the shoulder (regardless of the gender and age of the client), take the client by the hand and give the opportunity to take my hand in his own (regardless of the gender and age of the client), allow him to hug me (such requests more often come from women, and only occasionally from men), to hug the client (only women and men are younger than me, this is an interesting question and to a certain extent the obvious answer for me is “professionalism”, “the role of a specialist” are not able to eliminate the primary sexual identity).

In conclusion, I will tell you one story about the violation of any boundaries of the therapist in relation to the client. The mother of fifteen-year-old Igor (name has been changed) brought her son to a therapist, feeling that her child is withdrawn, shy of girls, behaves awkwardly and, obviously, suffers from this. On one occasion, a mother who came to the end of her son's session saw the therapist beating her son by the ears. The next day, the mother, who did not understand what this therapeutic approach to her son was all about, called the therapist to clarify the situation. When asked by the mother what the therapist did to her son's ears, the therapist replied: "I can't help it, he is so cute with you." It must be said that the teenager was really able to awaken the affection that people often feel when looking at chubby babies, but the teenager was already 15 (!) Years old and he needed self-affirmation in the sexual role and growing up, and the therapist's actions could only enhance his infantility and a sense of isolation.

I recall one therapy training event, when everyone, including the facilitators, participants, acquaintances, little acquaintances, who saw each other for the first time, hugged without ceasing. Then my friend at the end of this event said: "Listen, how you want to wash." It is a pity when therapy, therapy training turns into clownery, "hugs" steal the opportunity, albeit rare, but genuine human hugs. However, you can hug and touch without hands.