In W. Schiff & E. Foulke (Eds.). Basic Books. These elements might include: clothing, makeup, pens, pipes, belts, pillows, etc. Not to touch any clients at any time can be experienced as abusive as the original neglect to the … infant inside the adult client” (as cited in Norwood, 2017, The Use of Touch in Therapy Today section, para. Retrieved from http://aolsvc.health.webmd.aol.com/content/Article/14/1687_50119.htm?printing=true. Holub, E. A., & Lee, S. S. (1990). Online Continuing Education for Mental Health Professionals - Over 125 Courses Offered, Artificial Intelligence (AI) & Mental Health, Motivational Interviewing & Performance Psych, Autism Spectrum Disorder: What Every Clinician Needs to Know, https://www.zurinstitute.com/licensing-board-approvals/, https://www.zurinstitute.com/ada-policy-grievance, Touch in Ethical and Legal Aspects of Touch in Psychotherapy, Touch and the Standard of Care in Psychotherapy, Guidelines For The Ethical Use Of touch In PsychoTherapy, Working with a child that resists schoolwork, What you can do if your child appears anxious or depressed, Managing your child’s (and your own) anxiety and worry. (1995). Wolberg, L. R. (1967). You'll come away from each session looking at your own cases with fresh eyes. “Your body is your unconscious mind, and you can’t heal it by talk alone” (Pert, 1997, p. 306). ), Psychotherapy research: An international review of programmatic studies (pp. The relationship between ethnicity and touch has direct implications for touch in psychotherapy. Attorneys’ advice columns seem to have become a regular feature in our professional journals. Formative psychology was developed by Dr. Keleman (1981, 1987). (1994). At the same time however, many therapists and all somatic therapists believe that a client will have great difficulty in fully recovering from such trauma if only verbal or cognitive approaches to therapy are used. Still, graduate and professional education pays almost no attention to non-verbal communication (O’Connor, 2017). Touching clients can hurt them if done in the wrong way, but touch can also heal old touch injuries. Body-centered Therapies: History, Reichian, Bioenergetics, Radix, Somatic Experiencing. The perinatal bonding project: Infant massage to reduce child abuse. This includes, but are not limited to, such disciplines as: The Lomi School, which mixes Gestalt therapy with Reichian breath work, body education, biodynamic psychotherapy, Meditation, Yoga and Tai Chi and Stanley Groff’s Holotropic breath work. Biochemical Links between Consciousnesses, Mind & Body Energy To disregard all physical contact between therapist and client may deter or limit psychological growth. Counseling across cultures (4th ed.). Therapists, as this article articulates, also struggle with issues of touch in an increasingly adversarial legal and cultural environment. (1995). This live webinar is fully interactive. The medicinal aspect of touch has been known and used since earliest recorded medical history, 25 centuries ago. Topic: Therapy in a Time of Change: Building Resilience The unduly restrictive analytic, risk management or defensive medicine emphasis on rigid and inflexible boundaries and the mandate to avoid touch interferes with human relatedness and sound clinical judgment. At the same time it is important that therapists humbly accept that some clients are more powerful than they are and acknowledge the limitation of how much power and influence they really have. D.C., August. Journal of Counseling & Development, 66(9), 432-433. https://doi.org/10.1002/j.1556-6676.1988.tb00906.x, American Academy of Child & Adolescent Psychiatry. Registration is free but required. Stopping therapy in order to engage in sexual touch or sexual relationships is unethical and often illegal. Factors, such as culture and personal preferences, can permit such arbitrariness in boundaries (Bellehumeur & Chambers, 2017). It then discusses the psychotherapeutic benefits of touch and finally provides a summary and a set of guidelines for the use of touch in therapy. info@beckinstitute.org. It remains a potent and some would say the most powerful form of communication throughout the course of one’s life, holding immense potential for use and misuse, for healing and for harm. The cultural tendency in the US to sexualize most forms of touch facilitates confusion differentiating between medical, sensual and erotic or sexual types of touch. When: Five Thursdays starting 9/17, continuing 10/1, 10/15, 10/29 and 11/12. Rogers (1970) discusses the value of touch and describes specifically how he has soothed clients by holding, embracing and kissing them. Sexualization of innocent touch has a long history. Finkelhor, D., Turner, H., Wormuth, B. K., Vanderminden, J., & Hamby, S. (2019). Sensitive, attuned touch gets etched into our developing neural pathways enabling us to feel of value, and to connect emotionally with others. Rutter, P. (1989). This attitude goes along with Pope’s (1982) and his followers’ assertion that non-sexual dual relationships often lead to sexual dual relationships. This includes situations in which the therapists must physically intervene by restraining, holding or escorting the client away so he or she will not hurt someone else. The United States Association for Body Psychotherapy (USABP) (2003) asserts, “All experiences, as well as distortions and denials of reality and other defensive maneuvers, are reflected not only in peoples’ thoughts and feelings but also in the way they move, how they breathe and how the structure of their bodies has evolved over the years”(Para. Touch has often been placed at the top of the ‘Do not do’ list. Massage therapy effects. Psychotherapy: Theory, Research, Practice, Training, 46(1), 97-111. https://doi.org/10.1037/a0014751. As risk management becomes more prevalent, its effect is clearly seen on new therapists. Therapists are not paid to protect themselves, they are hired to help, heal, support, etc. (2017). Rethinking “Don’t blame the victim”: Psychology of victimhood. In fact, many analysts have viewed even appropriate and helpful boundary crossings, such as a comforting hug or hand holding, as poor boundary management. Hampton Press. Persons of a higher class may touch persons of a lower class, but not vice versa. Similarly, Gottlieb (1993) lists power differentials as the first dimension in the decision-making model for avoiding exploitative relationships in therapy. Extensive touch should be incorporated into the written treatment planning. Hall, J. Cascio, C. J., Moore, D., & McGlone, F. (2019). American Journal of Psychotherapy, 46(4), 544-555. The vital touch. Clinically appropriate touch must be employed with sensitivity to clients’ variables, such as history, gender, culture, diagnosis, etc. (2015). International Journal of Neuroscience, 84. Boundaries in psychotherapy have been a topic of growing debate in the past several decades, with touch being a central element of the issue. Using touch in therapy may be the only way to heal some of these disturbances. He works with breath, movement and sound as he examines the vibratory processes of the body down to the cellular level. The Report of the Task Force on Sex Bias and Sex-role Stereotyping in Psychotherapeutic Practice appropriately cautions that any treatment modality reserved for only one sex may be interpreted as being sexist (Redleaf, 1998). For example, a light touch on the arm by a therapist meaning to be supportive and affirming may be experienced by a client either, as intended, supportive, warm, encouraging and affirming, or it may be perceived as hostile, intrusive, controlling and disrespectful. (1978). This energy is simply called “bioenergy” (Hunter & Struve, 1998). If you can’t attend the live webinar, a recording will be available. Topics include: We will leave plenty of time for Q&A. When working with clients who have a history of abuse, it is of crucial importance that the client’s permission be requested prior to making any physical contact. For theoretical reasons, psychoanalytically oriented therapists are opposed to any form of touch. In Western society, sex, love, power and dominance are dangerously confused. Journal for Specialists in Pediatric Nursing, 24(2), 1-7. https://doi.org.10.1111/jspn. Out of bounds. Inner City Books. Greenwood. About the Instructor: Claire Nana LMFT is a licensed marriage and family therapist with over 15 years’ experience studying, writing about, and facilitating post-traumatic growth. For Kelley, the focus is on education and growth. Once a strong therapeutic alliance has been formed, Cornell (1997) indicates: The use of touch will evoke, address and hopefully help correct such historical experiences and distortions as: deprivation and neglect; over stimulation, intrusion and bodily violation, sexualization, parental narcissistic use of the child; deadening of vitality or use of the body as an instrument. The Exploitation Index: An early warning indicator of boundary violations in psychotherapy. in children and adolescents: A systematic review and meta-analysis. After attending this course, participants will be able to. https://www.psychologytoday.com/us/blog/talking-about-trauma/201707/hands-approach-psychotherapy. Therefore we must touch clients when appropriate in a way that will help them grow and heal. Ethical touch is the touch that is employed with consideration to the context of the therapeutic relationship and with sensitivity to clients’ variables, such as gender, culture, history, diagnosis, etc. https://www.apa.org/ethics/code/ethics-code-2017.pdf, Anisfeld, E., Casper, V., Nozyce, M., & Cunningham, M. (1990). He subsequently became fascinated with verbal analysis and the only aspect of his somatic perspective that remained a part of his focus was his technique of working with his clients as they lay on a couch. Therapist-patient sex as sex abuse: Six scientific, professional, and practical dilemmas in addressing victimization and rehabilitation. The project’s 40 volunteers provided training in attunement and massage to parents who were identified by social service agencies as being at high risk to carry out abuse. Tavistock. While accountability is an important civic quality, this lawsuit-happy culture, combined with the culture of victims, creates an atmosphere of dread that changes the way we do (or don’t do) business, play or healing. Factors that are associated with congruence are clarity regarding boundaries, the patient’s perception of being in control of the physical contact, and the patient’s perception that the touch is for his/her benefit rather than the therapists. (1993). North Atlantic Books. Within three weeks of conception, we have developed a primitive nervous system which links skin cells to our rudimentary brain. Understanding intercultural communication. Understanding Autism in Adults and Aging Adults. Communicating with the elderly. Guilford Press. (1991). Psychotherapy codes are used for billing clients and filing health insurance claims with all third-party payers, including Medicare and all private health insurance carriers, for psychotherapy services. Zur Institute maintains responsibility for this course. Pederson, P. B., Draguns, J. G., Lonner, W. J., & Trimble, J. E. About the Instructor: Diane McLendon, LMFT, is a practicing therapist based in Portland, Oregon. We are extending this knowledge and wisdom to the general public through dynamic webinars on timely topics and our e-newsletter offering tips and resources for ways to best meet and manage challenges that arise in day-to-day living. Thursday September 24th, 2020. Delores Krieger, PhD, RN, professor emeritus of Nursing at New York University, and Dora Kunz, a gifted energy healer, developed and standardized the technique in the 1970s. ), Tactual perception: A sourcebook (pp. The traditional dualistic Western mind-body or mental-physical split manifests itself in Western medicine, including psychotherapy. A therapist’s hug, meant to be supportive, may be experienced as affirming and calming, or as overwhelming, intrusive or as sexual harassment. Non-erotic or non-sexual touch in therapy, like any other form of non-verbal communication, can complement, negate, reinforce or alter verbal communication in general and in therapy (Geib, 1982; Horton et al., 1998; Phalan, 2009; Smith et al, 1998; Young, 2005; Zur, 2007a, 2007b). Tomm, K. (1993). al., 1985). Similarly, WebMD (1992) announces: A Hug-Free Zone: The threat of lawsuits, the already strong language in the APA code, and the general litigiousness of society have prompted many therapists to erect barriers between themselves and their clients when it comes to any physical contact. Dr. Stanley Keleman, Formative Psychology Montagu (1971) postulates that this type of parenting would produce individuals who are able to lead lonely, isolated lives in the crowded urban world, with its materialistic values and its addiction to things. ACA Code of ethics. O’Connor, T. S.-J. Gestures are also often unconscious or unintended modes of non-verbal communication. More recently, risk, There are many different approaches to touch in therapy. (2017). The western cultural context and its relationship to touch are also discussed as an additional source of the prohibition on touch. Psychotherapy: Theory, Research, Practice, Training, 35(2), 269-280. https://doi.org/10.1037/h0087817, Edwards, D. J. This paper discusses this potential discrepancy, suggests ways to minimize its occurrence and provides guidelines for therapeutic interventions. This has been interpreted by most researchers to mean that therapists who differentiate between those with whom they will employ touch in therapy are sexualizing touch and are also more likely to violate the sexual boundaries of therapy. For questions, concerns, or to request special accommodations, please email support@zurinstitute.com, A Free Live Webinar Psychotherapy: Theory, Research, Practice, Training, 34(3), 238-249. https://doi.org/10.1037/h0087717, Willison, B. G., & Masson, R. L. (1986). Journal of Consulting and Clinical Psychology, 51(1), 132-138. https://doi.org/10.1037//0022-006X.51.1.132, Craig, J. D. (1991). Sue, D. W., Ivey, A. E., & Pedersen, P. B. He used pressure on muscles, expressive exercises, and breath work and worked with dreams, memories and emotions that might emerge from the unconscious as a result of the bodywork (Lowen, 1976). (1971). (1994). Rutter, P. (1989). Ritualistic or socially accepted gestures, Preventing someone from hurting self or others, Therapeutic intervention – A bodytherapy medical technique. Journal of Adolescence, 5(1), 31-38. https://doi.org/10.1016/S0140-1971(82)80016-X, Durana, C. (1998). Never let them sit on your lap. Gender issues It underlines most arguments against the use of physical touch by therapists. Ethics & Behavior, 4(3), 267-273. https://doi.org/10.1207/s15327019eb0403_12, Borys, D. S., & Pope, K. S. (1989). Chapter 7: The development of tactile perception. Touch healers who had long been honored by their communities gradually lost clout. Getting in touch: The guide to new body-centered therapies. Zur, O. Perhaps one of the more important significant findings is reported by Holroyd and Brodsky (1980). Boundary crossing may be simply seen as a departure from the traditional, rigid psychoanalytic approach or inflexible risk management proceedings. Caregivers are taught simple stroking techniques involving the amount of pressure, pace and consistency. Therapists should not avoid touch out of fear of boards, attorneys or dread of litigation. These mechanisms provide animals with a built-in, natural or innate immunity to trauma that enables them to return to normal in the aftermath of highly “charged” life-threatening experiences. Lakin, M. (1991). was popularized by Dr. Eugene Gendlin in the 1960’s. Givens, D. G. (2004). Some, as we see monthly, have given attorneys a regular column in their newsletters or journals where this paranoiac thinking is disseminated. Midwesterners who are strongly rooted in German and Scandinavian cultures are relatively restrained in their touch behaviors. Identify features of autism in adolescent, adult, and aged adult clients. When it comes down to it. Infant massage and quality of early mother-infant interactions: Are there associations with maternal psychological wellbeing, marital quality, and social support? 1-37). Nonsexual dual relationships. In E. A. Margenau (Ed. While the actual likelihood of a lawsuit or of licensing discipline for psychotherapists is extremely low (Williams, 1997), in the rare event that it takes place, it can be very costly to the insurance company and emotionally and financially devastating to the practitioner. Edwards, D. J. Mead, M. (1955). Abreactive work with sexual abuse survivors: Concepts and techniques. Norton. Harlow, H. F. (1971). In R. J. Langs (Ed. If you must, kiss them on the head when they say goodnight. Infant Observation, 8(2), 115-123. https://doi.org/10.1080/13698030500171530. This program is not eligible for CE credits. An experimental study of the effects of increased physical contact on the development of attachment. (Definition) Mindfulness, from a therapeutic, secular perspective is a conscious awareness of our present moment.This includes openness and non-judgment about the experience. Clinicians are cautioned that for men, who generally do not give or receive nonsexual touch, regression transference may be elicited by the use of nonerotic touch in psychotherapy (Downey, 2001). The most recent survey found that 49% of children ages 0-9 are subjected to spanking and 23% of youth ages 10-17 are subjected to spanking. The silent language: Implicit communication of emotions and attitudes. The Report of the Task Force on Sex Bias and Sex-role Stereotyping in Psychotherapeutic Practice appropriately cautions that any treatment modality reserved for only one sex may be interpreted as being sexist (Redleaf, 1998). This webinar addresses that very question. We are familiar with these concepts as they relate to behavioral classical conditioning, and we are familiar with the common “aha” experience in psychotherapy. University of Ottawa Press. Developmental Cognitive Neuroscience, 35, 5-11. https://doi.org/10.1016/j.dcn.2018.04.009, Chen, S.C., Yu, B.Y., Suen, L.K., Yu, J., Ho, F.Y., Yang, J.J., & Yeung, W.F. Psychotherapy: Theory, Research, Practice, Training, 32(3), 443-457. https://doi.org/10.1037/0033-3204.32.3.443, Hovdestad, W. E., & Kristiansen, C. M. (1996). (1994). It is possible that many therapists cling to the false ideals of the segregated therapy session and avoid dual relationships because it increases their professional status (Dineen, 1996; Zur, 2000, 2001, 2007a). One study examined the effects of massage therapy on anxiety and depression levels and on immune function (Ironson, et al., 1996). [Master’s thesis, Dublin Business School]. At the time of this tragedy, the pain of her loss was, of course immense; she could not stop crying and was contemplating suicide. Fosshage, J. L. (2000). The natural history of therapist sexual misconduct: Identification and prevention. Clients might further be instructed to deliberately engage in various types of touching activities, such as touching trusted friends or animals, massage, or contact sports. Sexual feelings in psychotherapy: Explorations for therapists and therapists-in-training. The Importance Of Touch While preventing a client from hurting him or herself or others may require some physical intervention, physical punishment by a therapist is never appropriate in the context of psychotherapy. Social touching. Studies in bonding also show that human babies who are held often and touched frequently in their earliest stages of development have higher scores on physical, emotional, and interpersonal scales (Field et al., 1996; Klaus & Kennell, 1976). Alleviating posttraumatic stress in children following Hurricane Andrew. Researchers have intensely studied non-verbal communication with children and adults and in courting behaviors. Americans tend to sexualize or infantilize the meaning of touch and as a result tend to avoid touch. (1998). Americans of Mediterranean heritage touch and kiss freely (McNeely, 1987). Eight years later, addicted to Valium and alcohol, she began therapy with me. He believes that the quality of this pulsation shapes our physical form. Traumatic memories are encoded in our sensorimotor system as kinesthetic sensations and images, while the linguistic encoding of memory is suppressed. Professional Psychology: Research and Practice, 25, 247-258. https://doi.org/10.1037/0735-7028.25.3.247. O’Keefe, D. (2016). Touch is one of the most essential elements of human development, a profound method of communication, a critical component of the health and growth of infants, and a powerful healing force (Barnett, 2005; Bowlby, 1952; Bremner & Spence, 2017; Cascio, et al., 2019; Harlow, 1971; Sehlstadt et al., 2016). Journal of Personality and Social Psychology, 37(1), 87-96. https://doi.org/10.1037/0022-3514.37.1.87. These mechanisms provide animals with a built-in, natural or innate immunity to trauma that enables them to return to normal in the aftermath of highly “charged” life-threatening experiences. Touch unleashes a stream of healing chemical responses including a decrease in stress hormones and an increase in seratonin and dopamine levels. The California Psychologist, 33(6), 32-34. Dual relationships between therapist and client: A national study of psychologists, psychiatrists, and social workers. © 1995-2020 ZUR INSTITUTE. As Lazarus and Zur (2002) articulated in their book. 52-68). In 1980, Holroyd & Brodsky titled their article regarding their survey, “Does touching clients lead to sexual intercourse?” Not surprisingly they also concluded that it “is difficult to determine where ‘non-erotic hugging, kissing, and affectionate touching’ leave off and ‘erotic contact’ begins” (p. 810). She has created 22 continuing education courses drawing on the fundamental concepts of post-traumatic growth and is also the author of Leverage: The Science of Turning Setbacks Into Springboards.
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