Touch in therapy

I must be in the mood for controversy!

The "my psychiatrist kissed me" thread brought up the question of touch in therapy....which is a timely topic for me today, because T hugged me for the first time at the end of my session yesterday.

T and I DO touch - as a way to help me get grounded, and as a way to connect.

Yesterday in my session, we went deeper into trauma work than we ever have - WAY deeper. It was a 90 minute session, and it was just big, and hard. T sat with me and held my hands during the entire appointment. If he wasn't sitting there with me, grounding me, helping me feel safe, helping me to not feel alone, I don't think I could have done the work. There were so many flashbacks and I was so in and out of the present, that I think I would have been too scared and had to find a way to quit - or I would have just dissociated, and that would be that. It made me think that touch might be helpful in trauma work, in general. It wouldn't have been for me at the beginning of therapy....but I couldn't have done this kind of work at the beginning of therapy either. Over the course of my therapy, we've built the trust and the comfort with touch, and I think that's the only way I could do what I did yesterday.

At the end of the session, I felt really scared, heading back out into the world. I was afraid of what would happen if the flashbacks came back, and I was afraid I would look back at the session and worry about various things. T asked me "do you want a hug?" and I did, so he gave me one. It is really useful to me to be able to look back at the session and remember that symbol of our deep connection. It grounds me, and gives me something to hang on to besides the gut-wrenching intensity of the rest of the session.

Oh - and as I've mentioned before, I did have an adult male counselor cross the boundaries in the biggest possible way when I was a teen, so I know the value of boundaries, and I am grateful for them. I never thought I would feel safe enough to share a hug with a male therapist - EVER - and in a way the hug yesterday feels kind of like a symbol of some healing taking place. That feels good.

Hi earthmama,

T and I do not touch at all. I think once before I mentioned this--if he held my hand I would have freaked out and I suppose he knows this about me. As we get closer in the relationship I feel as though I might now be able to tolerate touch, but don't crave it. I don't think I could handle a hug at all and for me it would feel like a boundary crossing. It's interesting how others have been able to incorporate touch into their therapy. SIgh.

We have an intense and loving relationship but I've only shook his hand twice when my H came with me and there was hand shaking all around.

In fact, when I leave he often has his hands in his pockets. I think it's a way for him to not touch inadvertently. LOL

i am so glad he was just what you needed! Your's certainly isn't the first to hold the client's hand. i've never had one do that, and probably would freak right now, but i hear it is helpful a lot. but my t does hug, and it does help me feel loved.
i am glad it felt healing to you!!!!

My (male) T has never had physical contact with me. In fact, he has rarely been closer than three or four feet from me. This is what works for me; I don't know that he would behave similarly with another client who was more comfortable with contact.

I used to think that all physical contact was inappropriate, but I am now able to understand how some contact, such as brief touching or hugging, might be therapeutic. My T provides this to me in words, such as "I want to take care of you." Both physical touch and verbal expressions of caring can be invaluable. I certainly reflect on the verbal expressions often when I am feeling alone.

((earthmama))

I'm so thrilled that you had that deep connection with your T, and that you were able to get the hug that you needed!

I think touch can be very healing, when done in an appropriate manner.

For the longest time with T there was no touch whatsoever. One week I left the my session a complete mess. The next week, talking about it, I was able to eek out that I had wanted a hug, but I didn't think it was 'appropriate', so I didn't ask.

The next time I needed a hug, I asked. It helped me to know it was ok. It helped me to see that a person can touch another person in a purely supportive manner without wanting something in return. It helped me to ask for what I needed.

I've also squeezed the heck out of T's hands while just crying.
Sometimes T will touch my shoulder as I'm leaving.

This may sound strange -- but sometimes the shoulder touch, just that one moment of connection, is what sticks with me after I leave the session. All the words I said, the tears I cried are somehow not so important.

I understand the boundaries, and that it is vitally important for there to be no romantic touch. I do not mean to be too controversial, but I want to speak out in case there are others who are afraid to ask for what they need.

to all, and thanks to Earthmama for being brave and starting this topic!

Earthmama, I am glad that you are able to experience that safe physical contact with your T, and that it helps you.

My old T and I had physical contact. During or after trauma work she sometimes sat next to me and held my hand, and we usually hugged at the end of each session. Sitting next to each other was so gounding and so safe for me. I am glad she was able to do that.

For us it seemed natural and human. We were with that T for 8 years, and the bond was strong. If we started with another T I think it would take a long time for it to feel safe enough for physical contact, if it ever did. I think the appropriateness of physical touch in therapy depends on each unique therapeutic relationship. Some T's will touch, and some won't, and for some clients touch can be healing and useful, and for others it would not ever feel appropriate. I think touch in therapy can be a powerful healing tool as long as the boundaries of ethical behavior are never crossed.

My former T that I had for many years would sit next to me and hold me almost every session. She hugged me and held my hand, and it was very healing to me. We still keep in touch.

I'm old school on this topic.

IMO, if the T is male, and the client is female, there is no place for touch. When I read scenarios involving touch, my mind says, "and why was touch required for that to be accomplished?". Touch seems like the easy way out of the hard work. Learning to be loved without a physical relationship is important to trauma victims,."Can't you love me and support me without using my body?"

I understand the importance of learning good touch - but IMO, that should be done with a same sex T, and within our real life intimate relationships. There is simply too much sexual tension in the T/client dynamic (read this board for instance, it needs a PG-13 rating sometimes) so the addition of touch just makes the transference and all the emotions more complicated.

So, if my T tried to hold my hand, I would likely smack him and fire him. Of course, he never would or he wouldn't be my T.

S

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Luce said:
Sitting next to each other was so gounding and so safe for me. I am glad she was able to do that.


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Yes - this is so true for me too. There is something about sitting next to each other for the really hard trauma stuff. I guess I've been alone with the trauma stuff for so many years - and to have him there, it feels like he is sharing it with me, and like some of the burden is lifted. It feels very symbolic, and very healing.

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Slippers said:
Learning to be loved without a physical relationship is important to trauma victims.


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For me, learning that touch can be safe is really important. To be able to be loved, and cared for, and touched in a safe way, with firm boundaries, is huge.

After the bizarre and terrible experience of a counselor crossing the boundaries when I was a teen and trying to get help with childhood traumas, I never thought I would be safe in a therapeutic relationship again. To be in this safe relationship, and to be able to have my hand held or be hugged without a huge amount of fear and panic is really big for me.

But I can certainly understand not being comfortable with touch too. I wasn't when I started therapy!!!!! I guess that's why there are 2349465845964 therapists out there who are all different from one another....hopefully we can all find what we need.

My therapist and I do not touch during therapy, even when doing trauma work. He sits across from me, but sometimes wheels his chair quite close so I can feel his reassuring presence and connect better.

The only deliberate touch is when we say good-bye at the door, we sometimes hug. It's not everytime, but usually when we have done particularly deep work or feel particularly close. Like maybe after intense trauma work or when we shared deeply with each other or when we worked through a lot of really emotional stuff. It's really good and I am glad we are safe enough to be able to do this. It brings us closer after those really close feeling sessions. At other sessions, that are a bit more superficial, we don't hug. It's not something I expect each time or demand. We didn't hug until quite a few months into therapy and we had established our relationship. It's great to have shared these hugs with my therapist.

I am very jealous. *pouts*

I long for touch in therapy. I told her I long for physical comfort. She said if she felt it would be helpful she would (letting me down easy here) but in the long run she doesn't feel it would be helpful to me. *really pouts*

I did get to hug her once though. After seeing her for a few months she had to have surgery and thought she was going to be out a couple of months. I asked if I could hug her and she said "sure!". So I got to give her a hug and wish her well. It was wonderful! (The surgery went well and she was only out a week thank goodness.).

I asked later if she would have allowed that if she had known about my longing for physical comfort (hug, etc) and she said Yes she thought it was appropriate for the circumstances or something like that. I suspect it will never happen again.

I'm so glad your T gives you what you need and what is helpful to you!!

((((((((((((((((((((((((((((( echoes )))))))))))))))))))))))))))))))

It's interesting how different schools of thought/approaches to therapy/whatever view physical touch.

I asked T about physical touch early in therapy, and he said that his mentor when he was learning to be a T was very into physical touch, because it is so healing. So, I guess that's where T is coming from.

(Ironically, I was asking because I wanted to be sure T would NEVER touch me - and I actually told him after he told me that to stand far away from me when I was leaving sessions so he wouldn't accidentally touch me. I had forgotten about that until just now)

It's hard when we need something from T and can't get it. ((((((((Echoes))))))))

One of my therapists sits by me and she huged me once. She asks and I give her permission. i am also learning that touch can be safe, and I think that with out this part of therapy I wouldnt be doing as well as I am. Sometimes she sits by me and I close my eyes and practice not flinching when she moves. I can close my eyes when she sits by me now. One time I asked her to put her hand on my arm, because at the dentist the hygenist did this and it helped me stay grounded. She has offered to hold my hand. Its so healing and and I am healing so much faster. I can handle people standing close to me at the store or whatever, I think that there is a big difference betwen human comforting contact with client permission and innapropriate touching or kissing. I think of this therapist now and I feel comfort and thats huge for me.

(( thanks earthmama ))

I was encouraged when she said she had read Yalom's "Love's Executioner" because he firmly believes in touch at each session, however slight.

It sounds like your trust has really grown and you feel better about being touched appropriately now! That's great growth, don't you think?!

My T seems to be really good at saying "No" lately!

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MINIME said:
She asks and I give her permission.

</div></font></blockquote><font class="post">My therapist asks for permission too. He says, "Share a hug?" And then we hug. Sometimes he has just put his arm around my shoulders and given a squeeze as I am leaving and doesn't ask for this, but if it is a full-on hug, he always asks. I thinks it's very sweet. (But maybe asking permission is just something they learn in therapy school in their Touch 101 class.)

I am so glad I am one of the lucky ones, whos therapist will provide comforting touch. In moments of deep distress she will sit next to me, hold my hand, put her arms around me and even stroke my hair. I find this of great comfort, in a purely nurturing way........although it was 2 years before this happened. I think that being able to have some form of physical comfort can only be beneficial, if it is in the best interest of the client. I dont know how I would feel it the therapist was a male though, as I feel very much that she is comforting the child within, much as a mother would, with comforting nurturing touch.

I think when used properly touch can be a powerful healing tool. I capitalize on this quite a lot in my own career.

Touch is not part of my therapy. My T is very kind and compassionate, but I cannot imagine her ever touching me. At this point I take great comfort in knowing that I do not have to deal with being touched. Interpreting the touch and then figuring out how to appropriately respond to it... is just not something I really want to add to therapy at this point.

EM, I'm glad you and your T have found something that work for you. I'm also glad that you have not allowed your previous counselor to steal this powerful healing tool from you. This is a true victory from my perspective.

My old T hugged me at my last session with her and it's something I've hung on to. It was probably one of the biggest hugs I've ever gotten, like even when my mom hugs me it doesn't seen as sincere as T's hug did. I didn't realize a hug could be that comforting. I'm not one that is generally comfortable with people touching me, I usually jump and my first reaction is to move out of the way (I'm not sure why). My current T and I do not touch, except for a handshake at our first meeting. I don't know what I'd do if he did hug me. At times I wish he would hug me, but unless he specifically asked, I'd be really uncomfortable but I'm even more uncomfortable asking him for a hug.

T and I worked together for around two years before there was ever physical contact... and it was a handshake, lol. A handshake after two years!

When I dissociate a bit, or get extremely upset, T pulls his chair very close and takes my hand. The first time he did this, he asked if it would be okay.

When we do EMDR he does the alternating taps on my knees. He also asked if this was okay.

It was pretty much made clear awhile ago, that there would be too much "stuff" involved if there was ever to be a hug.

I could go on and on about my thoughts about physical contact in therapy, but I'll probably do that tomorrow, as I'm too tired.

Another way to judge if the touching is inappropriate or not is who the touching is for. It would always be inappropriate if it is for the therapist's needs. If it is for the client's needs then it would be appropriate if the client gives permission and the needs are read correctly.