The Ethical Use of Touch in Psychotherapy

Mic Hunter, Jim Struve

SAGE, 1998 - Psychology - 301 pages

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

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 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 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 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

About the author

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

Bibliographic information

• Title: The Ethical Use of Touch in Psychotherapy; The Ethical Use of Touch in Psychotherapy, Jim Struve
• Authors: Mic Hunter, Jim Struve
• Edition: illustrated
• Publisher: SAGE, 1998
• ISBN: 0761903607, 9780761903604
• Length: 301 pages
• Subjects: Psychology / Psychotherapy / General