Use of physical touch in the "talking cure": A journey to the outskirts of psychotherapy.

Abstract

The present literature review examines how physical touch has been used by therapists with their clients in traditional verbal psychotherapy. Attitudes and practices of therapists are presented in a historical context, starting with physicians' treatment of female hysteria in the 19th century, and concluding with current issues of debate. The use of touch in therapy has been highly controversial ever since Freud stated his principle of abstinence. This paper intends to give an overview of the various positions of influential therapists on the use of touch and their rationale for touching or not touching their clients, including the contextual factors that have shaped the use of touch over time. Furthermore, research findings pertinent to the use of touch in psychotherapy are included. The review concludes with practical recommendations concerning the use of touch in the contemporary therapeutic setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

The Use of Touch in Counseling: An Ethical Decision‐Making Model

“…Although therapeutic boundaries may not be uniform from client to client, the slippery slope position maintains that understanding the difference between boundary crossings and boundary violations is essential for preventing harm to clients. Boundary crossings are often viewed as benign departures from commonly accepted clinical practice and may involve such acts as gift giving, bartering for services, or even using touch in counseling (Bonitz, 2008). Boundary violations, however, are departures from accepted practice that leave the client potentially harmed and exploited and the counseling relationship at risk, including sexual relationships between counselor and client (Bonitz, 2008).…”

“…Boundary crossings are often viewed as benign departures from commonly accepted clinical practice and may involve such acts as gift giving, bartering for services, or even using touch in counseling (Bonitz, 2008). Boundary violations, however, are departures from accepted practice that leave the client potentially harmed and exploited and the counseling relationship at risk, including sexual relationships between counselor and client (Bonitz, 2008). According to the slippery slope argument, although “infrequent boundary crossings can enhance the therapeutic outcome, repeated stretching and blurring of boundaries might be a precursor to more serious boundary violations, such as therapist‐client sexual relations” (Bonitz, 2008, p. 397).…”

“…Despite the therapeutic uses of touch and its recognized therapeutic effects, the use of touch in therapy has been controversial since Freudian times (Bonitz, 2008; Pinson, 2002). In his early practice, Freud routinely used touch with his patients but abandoned the practice when he concluded that touch was “a means of gratifying a patient's infantile sexual wishes, hereby keeping the patient fixated at an infantile level” (Bonitz, 2008, p. 393). Recently, several opinions have emerged in research literature concerning the use of touch in the counseling relationship.…”

“…As a result of an increase in lawsuits and patient complaints, and high malpractice premiums, considerable attention has been focused on the topic of touch within the therapeutic context (e.g., see Goodman & Teicher, 1988). This controversy is also fueled by cultural taboos and ethical and legal concerns, because there are currently no explicit ethical guidelines regarding the use of touch in counseling (Bonitz, 2008). Still, much of the recent research has focused on sexual relationships between counselor and client and less on other forms of physical contact that may occur (Stenzel & Rupert, 2004).…”

An integrative body therapy approach: The Neo-Functionalism approach

“…Supervision is fundamental for the therapist and helps to cement a proper therapeutic alliance. If there is no such alliance, then any body-related techniques can be confused as sexual, which could act against the therapeutic project turning it into something maladaptive (Bonitz, 2008;Phelan, 2009;Zur, 2007;Zur & Nordmarken, 2009). …”