The Ethical Use of Touch in Psychotherapy

Front Cover
SAGE, 1998 - Psychology - 301 pages
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This is an excellent book... long overdue... [it] provides ample food for thought and encourages discussion. I simply couldn't put it down. The authors... write passionately about the most basic human need - touch and being touched - as part of the overall healing process. Both authors draw on a wealth of professional experience in working with psychiatric inpatients, severely traumatised patients and sexually misued people to build the foundation of their views... the book encourages the reader to look into the dynamics of the therapeutic process in a new light' - The Psychotherapy Review

Is the bias against touch in psychotherapy justified? Is ethical touch an oxymoron? Can the recovery process be complete without healing touch? Mental health professionals are entrusted with the awesome responsibility of providing appropriate treatment for clients in a safe environment that nurtures trust, a necessary ingredient for optimum movement through the therapeutic process. Though treatment approaches vary, most modalities are verbally based and, in theory, exclude physical contact. Fearing that any form of touch would likely lead to sexual feelings or interaction, clinicians tend to shy away from the topic. In this book, however, Mic Hunter and Jim Struve skilfully demonstrate that touch - a most basic human need - is intrinsic to the healing process along with talk-therapy, regardless of the practitioner's theoretical orientation.

While the use of touch is a given in other health care settings, it remains a benefit denied as taboo in psychotherapeutic relationships, due to transgressors whose unscrupulous use of a valuable technique have marred its reputation. This book, which is based on years of sound research and clinical experience, encourages readers to conduct a meaningful self-reflection and explore possible misconceptions related to touch in order to rejuvenate its acceptance.

  

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Contents

The Physiology of Touch
3
The Evolution and Mechanics of Skin Sensitivity
4
The Structure of the Skin
5
Physiological Responses to Touch
6
Variations in Touch Perception
7
The Relationship of Touch to Memory
8
Touch and Psychological Development
11
Summary
15
The Therapist Has a Solid Knowledge Base About the Clinical Impact of Using Touch
142
The Boundaries Governing the Use of Touch Are Clearly Understood by Both Client and Therapist
143
Touch Can Be Offered to All Types of Clients
144
Consultation Is Available and Used
145
The Therapist Is Comfortable With the Touch
146
When Is It Clinically Advisable Not to Use Touch in Psychotherapy?
147
A Risk of Violence Exists
148
The Therapist Doubts the Clients Ability to Say No
149

The Influence of Touch on Socialization
16
Touch as a Tool for Interaction and Exchange
19
The Impact of Touch on Communication and Physical Development
23
Touch as a Facilitator of Attachment and Affect Development
26
Touch as a Facilitator of Separation and Individuation
33
The Relevance of Touch With Older Persons
40
Summary
42
Traditions of Touch Within Various Cultures
43
Christian and Other Religious Traditions
44
The Practices of Medicine
46
Child Rearing
49
Summary
50
Traditions of Touch in Psychotherapy
51
Psychoanalysis
52
Ferenczi
56
BodyOriented Psychotherapies
57
Bioenergetics
58
Human Potential Movement
59
Behaviorism
61
Sex Therapy
62
Hypnotherapy
63
Contemporary Factors That Influence Individual Views on the Use of Touch in Psychotherapy
64
Touch and Taboo
65
The Taboo of Touch Within Psychotherapy
67
Despite a Hostile Environment Touch Is Used in Psychotherapy
68
Our Position on the Use of Touch in Psychotherapy
69
Recommendations for the Field of Psychotherapy
70
Recommendations to the Reader
71
Summary
72
Clinical Application of Touch in Psychotherapy
73
Power Dynamics That Effect the Use of Touch in Therapy
75
An Introduction to the Dynamics of Power
77
Relevant Dimensions of Power
81
CulturalEthnic Norms
84
Gender Norms
89
Summary
95
Functions of Touch in Psychotherapy
96
Intention of Touch
97
Context of Touch
98
Expectation of Touch
99
Possible Negative Effects of Touch
100
Possible Effects of the Lack of Touch
102
Possible Positive Effects of Touch
103
Positive Functions of Touch
107
To Provide Real or Symbolic Contact
108
To Provide Containment
109
Summary
110
The Dynamics of Touch When Applied in Psychotherapy
111
Touch and the Variability of Meaning
115
TaskOriented Touch
116
Attentional Touch
117
Touch for Greeting and Departure
118
Referential Touch
119
Courtesy Touch
120
EmotionalExpressive Touch
121
Reinforcing Touch
122
Protective Touch
123
Touch for Catharsis
124
Sensual Touch
125
Sexual Touch
126
To Reorient a Client
127
To Access Memories or Emotions
128
To Communicate Empathy
129
To Assist in Enhancing Ego Strength
130
To Change the Level of Intimacy
132
As an Adjunct in Hypnosis
133
To Assist in Working With Past Traumatic Experience
134
Summary
135
Guidelines for Using Touch in Psychotherapy
136
When Is It Clinically Appropriate to Use Touch in Psychotherapy?
138
The Purpose of the Touch Is Clear
139
The Touch Is Clearly Intended for the Clients Benefit
141
The Use of Touch Is Clinically Inappropriate
150
The Therapist Is Not Comfortable Using Touch
151
Summary
152
Model Informed Consent Form
153
Documentation of Touch in Client Records
156
A Continuum of Touch
159
Language as Touch
160
SelfTouch
163
Touch by Proxy
165
Physical Touch
167
The Laying on of Hands
169
Hugging
171
Holding
173
The Importance of Observing a Clients Breathing
175
Summary
176
Specific Techniques and Case Examples involving the Use of Touch
177
Supervised Massage
179
Case Examples
181
The Heart Transplant
186
Role Plays
194
Summary
202
The Use of Touch in Various Modalities and With Specific Populations
204
Working With Couples
205
Working With Families
210
Group Psychotherapy
213
Working With Survivors of Childhood Trauma
215
Summary
218
The Use of Bodyworkers as an Adjunct to Psychotherapy
219
Establishing Safety
220
Remembrance and Mourning
222
Psychotherapists Concerns
223
Questions to Ask a Bodyworker Prior to Making a Referral
224
Arrangements
226
Summary
227
Excerpts From the Ethical Code of the Massachusetts Association of BodyCentered and BodyOriented Psychotherapist and Counseling Bodyworkers
228
Materials and Training Aids
229
Erotic Issues Within the Psychotherapy Relationship
231
Professional Standards Regulating Erotic Touch Between Psychotherapists and Clients
233
Research on Professional Conduct Regarding Erotic Touch
234
Problematic Behaviors Exhibited by Psychotherapists Prior to Erotic Contact With Clients
237
Time
238
Language
239
Place
240
Physical Contact
241
Clinical Considerations Regarding Erotic Issues as a Variable in Psychotherapy
244
Transference and Countertransference
245
The Therapist as Perpetrator
248
The Therapist as an Ideal Figure
249
Perpetrator Countertransference
250
Victim Countertransference
251
Therapist as Client Countertransference
252
Clinical Presentations Exhibited by Clients That Indicate the Emergence of Erotic Transference
254
Becoming the Special Client
255
Fear of Being Alone
256
Conclusions and Recommendations
257
Summary
258
Prohibitions to Erotic Contact in Professional Codes
259
American Group Psychotherapy Association
260
American Psychological Association
261
Examining Personal Views on the Use of Touch in Psychotherapy
262
Examining Personal Experiences
264
Questions to Consider
266
Questions to Identify Signs of Boundary Violations
268
Examining Beliefs That Can Lead to Inappropriate Touch Within Psychotherapy
270
Experiential Learning
271
Round 2
272
Round 3
273
Summary
274
References
275
Index
288
About the Authors
299
Copyright

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References from web pages

The Importance of Safe Touch In the Healing Process (Part 2 of 3)
... Hunter and Struve tell us, and vision becomes more dominant as we age, they do point out in their book, The Ethical Use of Touch in Psychotherapy, ...
www.suite101.com/ article.cfm/ did/ 115715

Paper on Touch
The ethical use of touch in psychotherapy. Thousand Oaks, CA: Sage. Publications, Inc. James, B. (1989). Treating traumatized children: New insights and ...
www.a4pt.org/ download.cfm?ID=9971

Bibliographies & Resource Listings
The Ethical Use Of Touch In Psychotherapy . Newbury Park, CA: Sage. Juhan, Deane & Dychtwald, Ken. (1998). Job's Body : A Handbook for Bodywork . ...
www.jimstruve.com/ bib.htm

To Touch Or Not To Touch: Exploring the Myth of Prohibition On ...
... Risk management, Prohibition of Touch & Slippery slope Argument; Summary; Guidelines for the Ethical Use of touch in Psychotherapy; References ...
www.zurinstitute.com/ touchintherapy.html

ABOUT THE ETHICS OF PROFESSIONAL TOUCH By Courtenay Young
Hunter , M. & Struve, J. (1998) The ethical use of touch in psychotherapy. (Thousand Oaks, CA. Sage) Quoted in May, John: p.117 ...
www.eabp.org/ pdf/ TheEthicsofTouch.pdf

Škola telesne psihoterapije
Hunter M. & Struve J.: The Ethical Use of Touch in Psychotherapy. Thousand Oaks: Sage Publications,1997. Janov, Arthur, The Primal Scream, Delta Publishing ...
www.tepsyntesis.org.yu/ literatura_inline.html

Issue 5 Summer 2000
Has developed a "Therapeutic Touch Protocol" that was adapted from The Ethical Use of Touch In Psychotherapy, co-authored by Jim and his colleague, ...
www.metropolitancounselingservices.org/ newsletters/ issue_5.htm

MIC Hunter libri - I Libri dell'autore: MIC Hunter - webster.it
The Ethical Use of Touch in Psychotherapy · The Ethical Use of Touch in Psychotherapy di Jim Struve, MIC Hunter - Sage Publications - October 1997 ...
www.webster.it/ vai_libri-author_MIC+Hunter-shelf_BUS-MIC+Hunter-p_1.html

About the author (1998)

Hunter has a Psy.D. in clinical psychology and specializes in the treatment of sexual addiction and other addictive disorders.

Bibliographic information