Physical Contact-- PDOC vs. T

OK, so I've been seeing T for two years this month. I have never had any type of physical contact with him-- none. Zero. Not even shaking hands. Of course the bigger issue of wanting him to hold me and all that is there-- but I think that at this point, even if T shook my hand, I would pass out from shock.

I saw my pdoc today for the 2nd time ever. At the end of the session we shook hands. He was so nonchalant about it; he extended his hand out to me like it was the obvious thing to do. I shook his hand and then realized that he is the 1st mental health professional I have ever had to initiate physical contact with me, with the exception of my 1st T hugging me on termination day.

I engage in physical contact with my patients as long as it's okay with them and I feel that it is appropriate. Three patients have initiated a hug, which I was okay with. Sometimes patients reach out and want to hold my hand while they talk with me. If someone is really out of sorts, I might say, "I am right here next to you. Is it okay if I put my hand on your arm now?" I often shake hands for hello and goodbye purposes.

Does my T think that if he even touched my hand, all would fall apart? That I would jump on him? That I would spiral into a horrific mess of erotic transference and never come out?

I don't expect him to hug me, or even touch me on the hand. But that doesn't mean that I don't want him to. I need to sort out all of this strangeness.

Do I tell him? Do I say, "Hey... by the way, Pdoc shook my hand.... isn't that weird? You never shook my hand. What the %#@&#! is wrong with you?" lol

I always shake everyone's hand - How can anything erotic come from that??
All the doctors I've ever been to psych plus others have always offered me their hand and looked me in the eye and introduce themselves and if I bring my parents they also shake their hands.
We have been taught there is a place for therapeutic touch but it is a very personal thing left up to the clinician. Although males are warned to be careful when alone with female patients, especially vulnerable ones as they can often misinterpret things and it just takes one accusation to end a career. I think your male T is wise to stay away from touching, especially since you recignise the transference issues - there are just too many potential problems but I find it odd he didn't shake your hand on your first visit. It would seem odd to shake his hand after seeing him for so long.

Does he intentionally stay away from you - by walking a distance ahead/behind you, or acting awkward if you are next to him? That would be weird

my T is female and physical contact is extremely rare... Maybe its just his 'style'. dunno

my t shook my hand the first time i met him. i figure he was trying to see how anxious i was (kaplan and saddock say that a handshake can clue you in to anxiety by way of dampness and / or heat). in preparation... i always go bathroom, wash, and THOROUGHLY DRY my hands just before going in to that first appt. serves me well everytime mwah haha! I don't want them feeling a hot clammy hand when they first meet me. ew :-( its pretty %#@&#! obvious how anxious i feel sometime in the first five minutes at any rate.

personally... maybe i'm a bit odd... but personally i do find handshakes a bit erotic. can't help it sorry (blush). not in all contexts, of course... but i think therapy is kind of an erotic situation in the first place. i think firm boundaries with touch are important. and precisely where those firm boundaries are placed differs for different clinicians and it can be different with different clients too. (you might find that you would prefer less touch with clients if you have the experience of one of them declaring undying love for you and / or making a sexual advance towards you and / or flinching away from you and / or threatening to sue you for sexual misconduct. or... maybe not. different therapists have different boundaries that work for them.

i wish my t could hold me.
but i'm too big at any rate.
too big.
yuk yuk YUK

pink, my T never shook my hand until I started bringing my husband with me. At the end of the first couples session, as we were going out the door, T shook my husband's hand. I thought, well, this is interesting, he never shakes my hand, but then he reached to shake my hand too, after my husband's. But I actually got a two handed shake. Husband got a regular one hand shake, I got both of T's hands on mine. Hee hee, guess I'm special. This pattern pretty much maintained itself for the duration of our couples sessions. Once they were over, T went back to not shaking my hand at the close of sessions. I think it was a guy-to-guy thing, and since I was present also, T felt he had to shake mine too. Weird dynamic! Of course, I have gotten some sideways little hugs from T too (but never in the presence of my husband) and a couple of frontals. But overall, we don't really have a touchy thing going on. Usually, there is no physical contact at all. The hugs have been only after really intense and difficult sessions that were really hard work, ones where we felt particularly close.

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You never shook my hand. What the %#@&#! is wrong with you?"

</div></font></blockquote><font class="post">Good question! Go for it. If you really want a handshake, try bringing your husband along and see if this brings out the handshaker in your T.

Wondering - when you make a decision to reach out and touch a client, does their gender make a difference? does your supervisor or profs offer an opinion on touch in sessions?

Just due to the power differential, I'd imagine it's even a bigger deal if the T is male. Do they talk about that in school? What do they teach these guys?

Campy

I don't think there's as much at stake with the PDoc, they're thinking of themselves as "regular" doctors? I wouldn't have any trouble shaking hands with a doctor/lawyer/business person but anyone I personally care for but who isn't related, that is harder to do.

I think touch can be very, very therapeutic. My therapist hugs me every session, sometimes more than once... She holds me/us if we're crying, sits by us, holds our hand, etc. I even call her to come in after hours for extra hugs when it's been an extremely rough day. It is something, however, that is supposed to be initiated by the client. So I think you have to point-blank ask him "is it ok to ask for a hug" and brace yourself for the response to go either way.

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Campanula said:
Wondering - when you make a decision to reach out and touch a client, does their gender make a difference? does your supervisor or profs offer an opinion on touch in sessions?

Just due to the power differential, I'd imagine it's even a bigger deal if the T is male. Do they talk about that in school? What do they teach these guys?

Campy

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Personally, when I touch a client, gender does not make a difference. Rather, I evaluate boundaries and the appropriateness-- will touch benefit the patient therapeutically? does this patient have boundary issues? is this patient sexually preoccupied? etc., etc.

It is something that happened very naturally for me and it was a wonderful way to get to learn who I am as a therapist and how that shapes my style-- Before I started my internship, I said... no physical contact. None. I will not touch a patient. I took a lot of cues from my own experience in therapy, and I also tend to idealize my own T-- so I pretty much figured what he was doing was the way for me to do it, too. Once I began working with the patients I learned that the 'no-touch' clause was not my style at all. I have seen patients benefit enormously from a small amount of physical contact, i.e. holding onto my hand while talking.

Physical contact is not something that we have really been taught about in school. Women largely outnumber the men in my program. Before this semester, I really never had more than 2 or 3 men in my class. Sometimes zero. In one my classes this semester there are more men than usual in the class... it's a sexuality class where we watch "educational videos" so go figure on that one, lol..... But as far as physical touch, that it something that is an individual decision that can better be learned in our internships rather than in the classroom.

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smiley1984 said:
It would seem odd to shake his hand after seeing him for so long.

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It would be quite funny to shake hands after 2 years.

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Does he intentionally stay away from you - by walking a distance ahead/behind you, or acting awkward if you are next to him? That would be weird

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Maybe that's why he always rolls the chair back 50 feet when I sit down. Hmmm. We yell across the room to each other. Just kidding, lol.

What's interesting is I pick up on these cues and I end up taking it to the extreme. Like when I come into the room, he always hands me my chart so I can sign for each time I'm there. Then I pay him. So he hands me the chart and then I put the money on top of the chart and give it back to him. I can't even hand him the money, I'm so nervous I might accidentally brush his hand or something and then he might be like, "AH HA I KNEW IT!! YOU WANT TO %#@&amp;#! ME! GET OUT!!!"

Oh my God I just realized I have issues.

lol.

Help.

Unfortunately, I would rather stick my head in a toilet bowl and flush it than talk to him about this. So that's why I tell you ladies. Maybe I will get courage to bring it up. Doubt it.

so who do you tend to touch?

male clients?

female clients?

a mix?

have any of them expressed erotic feelings / desires?

would that make a difference to your touch policy with them?

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alexandra_k said:
so who do you tend to touch?

male clients?

female clients?

a mix?

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Both, plus anything in between (working with a transgender patient).

After group one day, I said good-bye to a male patient. He completely caught me off guard by hugging me. Normally if a patient is coming towards me with a random hug, I put my hand up and tell him "remember personal space-- a handshake is okay" Keep in mind that I work with patients who are acutely psychotic and sometimes have no idea of what boundaries are. However with this particular patient I had my hands full (CD player in one hand, art supplies in another) and he just went in for the hug, lol. It seemed very innoncent and I felt comfortable, so I let it happen. When I discussed it with my supervisor and his pdoc later on, both of them were totally shocked and said that when he first came to the hospital he was so paranoid he didn't want to talk to anyone and that reaching our for a hug was a huge step for him. I was really glad that I allowed it to happen because he obviously needed that.

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have any of them expressed erotic feelings / desires?

would that make a difference to your touch policy with them?

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Yes, I have had some of the male patients make comments about my body, or reach out to touch me. When this happens I remind that what is and is not appropriate. Simiarly, I had a female patient try to throw her arms around me in the first two minutes that we met. I do not get freaked out and say, "no touching!!!" rather I may just remind them that appropriate touch would be a handshake, and then I will offer my hand. Many of these patients are out of touch with reality or sexually preoccupied and need firm boundary reminders. These are not patients that I would necessarily hug, but I am not afraid to show them what is more appropriate. It is very different from the erotic undertones of the therapy that you or I attend.

I shook pdoc's hand, I believe on a couple of occasions. I have never touchd T or vice versa, with one exception. One day I was there with my son and husband for a family session (early on in my therapy) and he shook all our hands on the way out. It felt like a very different context than my individual sessions, and since the guys were shaking hands he shook mine too. I wish I had known at that time how attached I would become and how rare the event would be!

Strangely enough, my prof. was talking about touching clients today. She said, "I usually touch my patients, at least on the shoulder (if it's okay with them) on their way out the door. Do you realize that some people have not experienced any type of physical contact for years? It can be so valuable."

yeah. there was some paper i found a while back on 'boundary crossings' and on 'boundary violations' and it was saying the same thing. touch can be so theraputic when used appropriately. i think i get what you are saying with respect to the situations in which you see people. even in therapy... i guess a huge part of it is about how comfortable the clinician feels about it. i guess a lot of clinicians have an uncomfortableness about touch similarly to how a lot of clients do. and i guess it is harder for guys too because of all the focus on 'bad touching' etc.

I have a very squashed hand. I seem to be the resident hand holder at work when patients have uncomfortable things being done. They are usually too embarrassed to ask but if I make a joke and tell them it's my job, they clamp on!!!

I'm just totally clueless. I never really thought about physical contact until I read this thread. I don't think I really want to be touch by her. A hand shake would be OK, but I really don't think I need it. During my first session she said hello, I said hello, and then she lead me up stairs to her office. Now that I think about it.. the fact that I unconsciously choose to sit on the part of the couch furthest from her chair is probably a pretty good clue that I like my personal space. This thread certainly makes me wonder how many other non-verbal cues I project...Hmm