The Psychoanalytic Effects
What is the potential outcome for the patient and therapists when physical touch is introduced into a therapy plan? And possible negative impacts to using this form of therapy will be discussed. It is known that physical contact does occur and that is why the discussion is one that must be brought to light. In the article “The Human Touch: An exploration of the role and meaning of physical touch in psychoanalysis” Toronto (2001), Ellen Toronto brings to light a very controversial and uneasy topic among psychologists.
Because psychoanalysts see no logic for throwing out human touch as a means of “extra-analytic technique”, the Job f the human analysts becomes more defined and humane in regard to one on one therapy. Later in the article Toronto provides information on three case studies done where human touch was and was not beneficial for the outcome of therapy and explains the various reasoning behind why or why not the decision to touch was made. She also shares her personal convictions and conflicts when faced with this decision.
Toronto says that psychologists who study psychoanalytical techniques are against it and that many connect human touch and therapy with sexual intimacy or inappropriate interferences during treatment. Based off of the well balanced information given in this article, Ellen Toronto goes on to say that psychologists must become more cognizant of what it is that they are doing and hold into account that all forms of communication should be considered during phases of therapy.
The viewpoint of most psychologists regarding hugs or even handshakes between the therapist and patient has been very negative and confusing. Toronto claims that human touch and the fact that it is happening, regardless of how people feel about it has been overlooked and ignored in some respects by practitioners and should be acknowledged. There have been reports of physical activity between therapists and patient. Toronto mentions that others such as Preference, Wainscot, Casement, Mclaughlin and Marrow view touching as an important and necessary form of communication in regard to analytical work.
They believe that extra-analytic techniques such as self-discloser and holding are now viewed as very beneficial when performed cautiously and with regard to the situation. After further discussion between Toronto and her colleagues, she discovered that it does occur, usually with patients that are regressed, but the discussion was never formally admitted. Even though reasons for physical touch in the treatment form seem to be necessary, these acknowledgments from her peers seemed to be viewed as negative and guilt filled.
This is the very reason why Ellen Toronto deems it necessary to expose the interactions that occur among the analyst and the analyzed. It provides valuable information on situations involving touching as part of treatment and sheds light on the types of circumstances where physical contact might be necessary for patients missing certain developmental stages in their human development. Human nines begin; in that we start off as infants, without being able to communicate verbally and only through touch and bodily fluids, as do mother and child.
In the article, it is said that it is the mothering figure that sets the stage for early development. In the same sense the therapists possesses a comparable capability to provide a secure setting for the patient while also striving to understand what the patient is feeling or has felt. If a patient did not receive adequate time in this phase of life or if something traumatic happened directly after this stage then the patient is men as trapped in the “early mode”, which then allows for the touching portion of the therapy to take effect where verbal communication cannot.
Early manifestation of maternal erotic transference is briefly discussed in Torso’s article as being a transferred association of one’s feelings of maternal love and creating to one that allows the same unconditional positive regard. Mostly all of this is nonverbal and is difficult to create with only verbal communication. Toronto asks how a therapist is supposed to work with patients that are remaining at a nonverbal level in some significant phases of their experiences. And how does a therapist define safety, regulation, engagement and acceptance verses rejection issues, a lot of which are learned nonverbally.
Nonverbal communication has been viewed as a very existent part of therapy and so with regressed patients human touch can sometimes be the only link bridging the gap. Ellen Toronto approaches this topic with three case studies all involving the decision of physical touch as an analytical technique. The first two cases involved were both situations were Ellen believes physical touch of any kind would have had a negative impact on the outcome of treatment. The first case involved a man, mid ass’s, who had an affair that almost destroyed his marriage and in fear of it happening again, pursued mental health treatment.
He expressed to Toronto that he thought of almost all women in a sexual way and that the only reason for him not having another affair was lack of opportunity. After a while the patient, who Toronto calls Nick began to express his sexual attraction toward her. He also began to move his chair close to hers at the beginning of each session while also describing his fantasies of seduction for her. During this time Ellen describes her Houghton and reasoning by saying “l could have asked him to move his chair but I felt that this measure of control was very important to him”.
Ellen was also certain that Nick understood the limits in that he made no move to touch her throughout the entire treatment. She also reveals that inside she was not as calm and collected as she might have appeared on the outside. Nick in turn was able to express and explore the meaning of his behavior without participation or fear of drawback from his therapists. This technique gave Nick a space to express himself in a limited but useful way and after two years of treatment eventually discovered healthier ways of connecting and communicating with his wife and family.
The second case study shared by Toronto was one of a lady, mid ass’s, who’s failed suicide attempt and affair with her past therapists ultimately landed her in Ellen Torso’s care. The woman Ellen calls Cynthia was described by Ellen as very overwhelming with demands and spoke a mile a minute. Toronto describes how she believes Cynthia had lived a life of constant self-exploitation through sexual encounters with previous men. This was a humpty of Cynthia specific social-cognitive learning experienced early in life.
Cynthia also had a condition that Toronto explained as being a multiple, chemical sensitivity, which was a manifestation of an inability to cope with feeling overwhelmed and taxed by the world. Cynthia used this to control others, requiring them to respond to her illnesses as well as to shield her from being exploited. After a few reinstatement of what was and was not acceptable behavior during therapy sessions, Ellen was faced with a situation that required yet another drawing of the nine. Cynthia approached Ellen at the closing of a therapy session with a hug, but Ellen moved out of the way offering a hand shake instead.
Later on Cynthia conveyed her understanding that Ellen could not allow that, given the history of her last relationship with her past therapist. Toronto goes on to explain how later realizing that anything more than a one to two handshakes would have resulted in confusion and overwhelming burden on Cynthia part. Ellen also explained that is was time for Cynthia to experience a relationship where she was able to be safe and have a hence to explore her own feelings without worrying about another’s. Cynthia eventually went on to achieve some sovereignty and after two years of therapy eventually broke off her affair.
Toronto expresses in her article the personal frustration and dealings with the knowledge of Cynthia affair with a therapists and his continual exploitation of her throughout the years. The Sarah case study involves a young woman, mid- ass, who was addicted to food, cigarettes, and marijuana. She was ending a relationship with a former boyfriend and was in danger of being fired hen she initiated treatment with Ellen Toronto. Throughout the past two cases Ellen attempts to provide a solid and safe interaction with her patients and does the same with Sarah by allowing her to freely speak and be herself.
Ellen was able to dig up only fragments of Sarah’s view of her own childhood after years of therapy with her. She described Sarah as not really being able to recall anything about her mother or an event where her sister was hospitalized. Although it was not conveyed, many believe Sarah suffered from a traumatic amnesia or repression (Wade C. , & Atavist C. , p. 287). Ellen explains that over the years Sarah learned to verbally communicate after Ellen studied the nonverbal data gathered and built patterns of meaning through them.
Also Ellen explains that Sarah later became curious about Toronto and eventually desired to become closer to her. She thinks this change was an early manifestation of maternal erotic transference and discovered that Sarah was missing a developmental phase in her development that allowed her to verbalize what she was feeling. After a lot of time Sarah was able to start to verbalize what he was experiencing inside but later came to the realization that she was not able to “feel”. This began a request for Ellen Toronto to help her feel things. Sarah explained that the only way she could begin to feel is if Ellen held her hand.
Ellen believing that this may have been the only way to help her experience some sort of emotion, in which after years had never shed one tear. Sarah reached out for her hand and Ellen decided to take it. This eventually became more and more uncomfortable for the both of them and they eventually agreed to stop holding hands during the sessions. Ellen explains that she was feeling guilty for breaking the “no-touching” rule but that she was uncertain of a much more presence of fear that seemed to be shared by the both of them. Even though the decision was mutual, Sarah continued to ask to hold Allen’s hand, at almost every session.
With refusal of Ellen to do so she eventually was able to come to the conclusion that she could help Sarah with some but not all of her needs. Sarah eventually became more and more verbal in her disruption of what she was feeling and later went on to develop a way of expressing her moods by expressing various “selves”. CONCLUSION Ellen Toronto did a fantastic Job of conveying both sides of the issue of physical contact used as a form of therapy. Reports of what reactions each patient had and more interestingly what reactions she herself had to the possible introduction of physical activity between patient and therapist was eye opening.
Even though each case study was unique, Ellen was able to assess the possible dangers of introducing physical contact into each individual therapy session. She was able to possess complete control over the situation when physical contact was initiated by Cynthia, he second case study patient and when physical contact was verbalized by Nick, her first case study patient. However, physical contact was made between herself and Sarah, the other case study patient. The effects deemed to be far more emotionally influential than she had expected.
Ellen postured herself as the parental figure in this case more so than in the other case due to the emotional intelligence level of the patient. Her decision to take Sarah’s hand that day was a decision that came from a long relationship between the two and slow emotional development of the patient. Ellen conveys that she had done all that she could do and that maybe this would help. Although Toronto felt it may have been a bad choice at first, the article later explains how the developmental process with Sarah continued to change and gradually got better.
In each study done, help was ultimately administered. With case study 1, Nick was treated fairly and humanly, despite the inappropriate fertilization he decided to share with Ellen. Cynthia was given boundaries and a safe haven and ultimately was able deal with things in a healthier way. Sarah’s case as the only situation where it seemed Ellen Toronto became emotionally invested. Toronto was verbally asked to participate on multiple occasions prior to her decision to hold Sarah’s hand.
The other two cases involved nonverbal communication regarding physical touching, Nick sitting closer, Cynthia initiating a hug. Sarah insisted that holding her hand would help. Was Ellen manipulated into making the decision to break the “no-touch” rule? After doing so Ellen expressed regret for this decision. It’s not wrong that she used this form of therapy as treatment, but she old have possibly been emotionally invested more so than she realized which is why the decision was made to hold her hand and why it was also increasingly uncomfortable after doing so.
Maybe if so much time had not gone by before this decision was made to touch, Torso’s decision would have been different. The effect of this decision was confusion on both parts, as described earlier as being increasingly uncomfortable. This attempt at analyzing human beings with all forms of communication as we know it can definitely create unforeseen challenges and difficulties. Patients and therapists alike are human beings that come with individual feelings and perceptions.
More case studies should be done on people that do not have serious mental issues or anything major pending in their lives. How would it affect someone who is Just dealing with everyday issues like marriage, bills, or raising children? Would the report reflect that a short hand shake or hug during a therapy session could make them feel any more dependent on their therapist or would it help to comfort someone dealing with the pressures of life? What would this type of search do to help cultures that do not touch ever in their everyday interactions with one another?
Would touching during family counseling sessions help bridge the gap between conflicted family members or would it cause more uncomfortable feelings between each other? Studies like these could be done on people that have been confined in Jail because they have problems keeping their hands to themselves. Boundaries could be established and maybe victims of child molesters could become rehabilitated instead of Just another statistic. With this said, psychoanalytic psychology has a long way to go in the development of incorporating physical immunization into the therapy session.