I’m a firm believer in the power of love and compassion to open doors, change minds, and renew hearts. Sometimes, in order to be of help to someone in need, we have to reach out to people in ways we would have never thought we would. A random hug, a touch on the arm, a warm smile, and pat on the shoulder can all make this cold world a bit warmer. Touch has been a very powerful tool for me, as a therapist, during my 7 years of working with young clients who have severe trauma histories, have been abused or neglected, or suffer from severe mental illnesses. For many mental health professionals, the population of clients and the setting will determine if touch is appropriate. But for the rest of us, when should we or when should we not touch someone? It is difficult to tell. Unfortunately, because it is difficult to tell, many professionals in the mental health field shy away from touch and prefer to engage with clients with firm boundaries. This can lead to a lot of problems. For one, some clients work best with therapists who express warmth and compassion through touch. Secondly, mental health professionals who work with children and teens should reconsider the “no touch” policy. And thirdly, mental health professionals should re-examine under what circumstances is touch appropriate and not appropriate and if there should be rules for when to set stricter boundaries. During this time of the year when clients are struggling with the loss of loved ones, long-term relationships, or the basics such as food, income, or housing, touch can be a very powerful thing. This article will examine this very controversial issue still holding many therapists and other mental health professionals captive.
I love my profession. The ability to reach out to others and support them when needed is, for the most part, an honor. Mental health professionals are often the first line of contact for someone considering harming themselves or someone else. Therapists who work in crisis centers or inpatient settings are often the first people to help mak a difference in that person’s life. For me, making a difference does not only entail talking to someone (“talk therapy”), handing someone pamphlets, or referring them to another professional. But it entails a collision of science (i.e., research, skill, and knowledge) with art (i.e., compassion, understanding, and touch used appropriately). For many professionals trying to balance the two is difficult and sometimes outright tiring, which is why so many have a “no touch” policy at ALL times. But are we really making a difference that way?
Our society is starved for love and compassion. Society is constantly looking for new ways to feel emotional voids. Why? Because society, including the field of psychology, helps to perpetuate the idea that love and compassion are only for those people we know on a personal level or should be reserved only for special occasions (i.e., weddings, funerals, holidays, etc). For example, we don’t have to worry that our love and affection toward uncle Mit will ever come back to bite us in a lawsuit claiming sexual harassment. But with certain clients who misinterpret kindness, touch can lead to a lot of ethical and legal problem. It is important to emphasize that not all clients should be touched and not all therapists should become vulnerable with their clients. But it is also true that not all therapists should become cold, stoic “healers” for fear of lawsuits.
When a client hugs their therapist or asks to hug a therapist at the end of the therapeutic journey and says “thank you, thank you, I could not have gotten here without you,” isn’t that what psychotherapy is all about? I had the opportunity last year to ask multiple therapists and mental health professionals this question: “do you want to miss that moment?” I wish you could have seen the many faces in the auditorium and the fear and anxiety that seemed to grip each of them as they sat quietly scanning their mental bank for research to cite to the contrary. The truth of life is that we need one another, it’s sad that some are just too prideful and too fearful to see that. Sadly, some mental health professionals fall into this category and often end up stifling the growth of their clients out of fear of potential consequences. When you think about the multiple children and adolescents seeking approval and love in today’s world, the ability to communicate compassion and love through some form of touch is honoring.
Touch is a human thing that we cannot avoid. In fact, if we avoid touch completely, we miss very important emotional messages that we convey to each other through personal touch. We all know that there are different kinds of touch and some forms of touch are completely inappropriate, while other forms of touch can help convey fear, anxiety, uncertainty, love, compassion, or support. Unfortunately, some mental health professionals have used touch to dominate their clients (in sexual assault cases) or to intimidate others and be condescending. However, there are mental health professionals who use touch to convey equality, compassion, or concern. A handshake, a pat on the back, a nudge on the shoulder could all be used by a therapist to express how they feel about their client or the relationship that is being built. Laura Guerrero, coauthor of Close Encounters: Communication in Relationships, who researches nonverbal and emotional communication at Arizona State University, says: “if you’re close enough to touch, it’s often the easiest way to signal something….We feel more connected to someone if they touch us.” Touch is a very powerful form of nonverbal communication. As a result, I personally use appropriate touch with my young clients, when necessary, to convey empathy, compassion, and concern. I find it’s very beneficial for most kids.
There are 6 truths that therapists should consider and that I often consider before meeting with clients who might ask for a hug or initiate touch:
- We cannot avoid connection to others: As basic as this is to understand, some people forget that a connection to others is inevitable. Everywhere you go there is always someone around (movie theaters, stores, public transportation, parks, etc.). We are constantly in contact with each other. As a result, we should not attempt to avoid contact with others, but instead learn how to connect and make it appropriate.
- We are relational beings: When you are feeling depressed or anxious about something do you look for someone to talk to? Do you look for a friend or pet to comfort you? Do you feel better once you have been consoled? If so, this is because you are a relational being who relies on the comfort and love of others to cope. We all do. Life definitely hurts sometimes and to have someone near to provide comfort, can make the pain a bit more easy to cope with. Clients feel the same exact way.
- We should never neglect to use our intuition: It’s very important for therapists to be mindful of their client’s history of abuse, sexual assault, or other traumatic past that could cause a client to truly dislike being touched. Clients should also consider that perhaps their therapist has a trauma history too that could make touch undesirable. Other people don’t like to be touched due to fear of germs or fear of feeling inferior. It’s very important for therapists (and clients) to examine the benefits and consequences of touch. Personally, I allow my clients to initiate hugs and only allow touch from clients who understand healthy boundaries and has shown a great deal of respect or we both feel it is “safe.” It’s important that therapists protect themselves from clients who may attempt to use touch to manipulate them. Clients should also be wise.
- An inability to give of yourself can lead to therapeutic failure: I have had the unfortunate experience of witnessing therapist interns or therapists in training “fail” to connect with the person they are counseling and eventually face clients dropping out of session unexpectedly or not making great strides with certain clients. Some clients need a pat on the shoulder or a hug after a very tough session of crying or discussing very traumatizing details. Clients who are encouraged to create a “trauma narrative” by re-living some of their traumatic experience(s) can truly benefit from a hug or pat on the back. Sometimes this is the only thing that can move therapy forward for some people. My experience has been that some children and adolescents with traumatic pasts often benefit from touch, while others have a complete aversion to it.
- Touch is cultural and spiritual: Research conducted to explain culture and psychotherapy has shown that certain cultures favor touch over other forms of communication. The African American and Native American cultures are very spiritual and often use touch to convey powerful messages. Most Americans also use hugs or handshakes to greet each other, and the Russian culture uses touch (kisses) as a friendly gesture. For the most part, touch is cultural, spiritual, and social.
- We should develop a balanced view of touch: It is my experience that there are therapists who are completely opposed to touch out of fear of “crossing the line” with some clients. These therapists do not believe that touch is an important part of therapy and will use other forms of communication to convey compassion and empathy. However, there are other therapists who truly believe that touch is important in therapy and may cross the line with many clients. It is important that mental health professionals develop a balanced view of touch and learn how to utilize it when necessary.
Physical touch can be both a rewarding experience and a tricky experience for client and therapist involved. It is important that both individuals have a clear understanding of each other, respect one another, and even explore why touch is so important. Some clients come to therapy to obtain the loving feelings they did not receive from a parent or caregiver. This is okay, especially if it is appropriate. But it is also important that both client and therapist recognize that touch could be viewed as inappropriate with certain clients and should be limited. For example, if an adolescent male client wanted to hug his attractive female therapist every session, this should be explored and stopped. However, if an eight year old, severely abused, young girl felt the need to hug her therapist during her final few sessions, this could be explored as well and possibly viewed as healthy.
How do you feel about this topic?
Do you think you would benefit from a therapist who provides appropriate touch (periodic hugs, pats on the back or arm)?
What about certain groups: do you think elderly people or children/teens would benefit from touch or closeness from a therapist? Is this inappropriate? Why?
As always, I wish you well
Psychology Today. (2014). The Power of Touch. Retrieved May 2,2015, from, https://www.psychologytoday.com/articles/201302/the-power-touch.
Photo by Street matt
This article was originally published on May 2, 2015 but has been updated for comprehensiveness and accuracy.