The Use of Intentional Touch in Therapy

Judith Ashton

To start with, what is touch? Touch is one of the five senses. It’s a basic universal 
form of communication. It cuts through words. It’s non-verbal. It’s pre-verbal. And
 it’s the first language between the parent and the child, the first language the infant
 experiences. It’s the language of the body, sensation. It’s the language of feeling.
 Feeling has two connotations, two meanings: first of all, it’s tactile feeling and then 
it’s also emotional feeling. So right from the start I am very aware that, when I’m
 working with touch, it’s always an emotional experience. People talk about being 
’in touch’, ‘out of touch’, something ‘touches me’, a ‘touching’ experience, etc. It’s
 right there within the linguistic context.

In many cultures touch is a prevalent way of communicating. People caress each 
other. People massage each other. It’s part of communication. Sadly for many of us
 in the western world, perhaps because of the prevalence of the church or Victorian
 values, society or education, people are very out of touch with their bodies unless 
it’s within a sexual context. We actually need to relearn the whole language of non-
sexual direct physical communication. We’ve forgotten how to touch, when to
 touch, where to touch, etc. Direct touch has largely been lost because of modern
 technology and instruments within a medical context – physiotherapists, doctors or
 medical intervention – where there is a lot of mechanical touch. But we’ve forgone 
this basic human need and we’ve been supplanted by machines.

Working with Massage


Touch always has to be seen as emotional. You cannot separate touch from 
emotionality. It’s simply and utterly impossible. I would very much be aware of 
the emotional content of working with massage. Simply placing your hand on 
another person can bring up so much feeling. It always begs a relationship, as a 
reciprocity: I touch you and you touch me. Usually we permit touch from people 
we trust and we withdraw from people when we don’t trust or fear them. That’s
 very basic. That’s the ABC of touch and always has been.

Our relationship to touch goes back to our personal history, that has been
 determined by the tactile context within the family situation. Were you touched
 appropriately, were you touched lovingly? Was it comfortable sensation? Were
 your needs met? If there was good positive touch and good respectful parenting, 
then hopefully you’ll grow up fairly at ease with touch. But unfortunately we hear 
more and more about dysfunctional families, where people have been touched 
inappropriately and even abusively. Touch can be incredibly threatening. We have
 to be very aware of boundaries within this touching context: we must know who
 we allow to touch us, where we allow them to touch us and how we allow them to
 touch us.

Non-Sexual Touch

Certain professions have touch permission implicit within that context, example, a hairdresser, a doctor, a Physiotherapist or whatever. and within the context touch is acceptable. Touch used within a caring context is very powerful, if it’s used intentionally and consciously directed, as a deliberate act with a specific 
goal in mind. But touch for very many people is extremely threatening because of
 its sexual connotations.

A few years ago, I read a sociological report about non-sexual touching in
 European cities. Some sociologists went off to Greece, Italy and England to see
 how many non-sexual physical encounters they could measure within an hour in a 
public place like a cafe. In Greece they saw 400 slaps on the back, kisses on the
 cheeks, shakes of hands, etc. In Italy it was pretty much the same. But in London 
in a pub on Kings Road, it was something like four. They saw lots of sexual
 contacts but very little non-sexual physical contact. I think English people and
 Irish people have been fairly frosty and intimidated when it comes to touch, 
because it’s been surrounded by taboos and sexual innuendoes and all the rest. So 
it’s a loaded area and as such to be greatly respected.

Respect for the Body

I have been working with the body now for nearly twenty years and I always have
 a huge amount of respect for the body. It’s absolutely the crucible of your emotions.
 It’s the house of your soul. It’s something not to be worked with lightly. The
 implications can be huge. The healing potential is huge and the responsibility
 enormous. When you are working with touch you are touching something much
 deeper than the physical body.

My original training was as a neo-Reichian physiotherapist and body worker. 
Reich’s theories are now more widely respected and accepted than they were
 during his lifetime. He was one of the first pioneers who took the body and the 
language of the body into consideration and he coined the phrase, vegetotherapy,
 which is unique to him. It means any way of eliciting the emotions through the 
body. He didn’t simply work with free association. He didn’t work in disassociated way. He worked very much with the relationship with his client; he 
would encourage emotional expression. He worked with touch, he worked with
 massage, he worked with anything to loosen up that person so that their emotions
 could freely flow and that they could feel the benefit of the full range of expression.
 He said that, as young children, to stop our selves from feeling pain or hurt or 
difficult emotions, we created psychological defences. We put up certain barriers,
 so we did not fully experience pain, and they were lifesavers perhaps in that
 situation. Not only did we create psychological boundaries, but also physical 
boundaries, whereby we tightened our shoulders, we held ourselves a particular way, we inhibited our breathing or whatever. We created what he called muscular 
armour and character
 armour  and he said that muscular armour and character armour are completely and utterly invisible. He says that every muscular rigidity 
contains the history and meaning of its origin. So everything you’ve ever seen, 
tasted, touched, felt or heard has made an impact or imprint on your bodily self.
 You are not consciously aware of that, but certain things can waken up immediate 
recall. If you listen to a strain of music perhaps you will be immediately 
transported back to a disco in the 60’s; or Marcel Proust smelt the cakes baking and 
he was immediately transported back to his grandmother’s kitchen. All sense has
 an immediate recall. And of course, the sense of touch is very, very potent.

Reich also says that we hold all our stresses mentally and bodily. “The reality of 
the musculature is the somatic side of the process of repression and the basis for its 
continued existence.” In terms of treatment, he says that character attitude may be 
resolved by the dissolution of muscular armour and conversely, muscular attitude 
may be resolved by the dissolution of character peculiarities. Being aware of the 
intricate relationship between the mind and the body also makes us aware that 
touch is the bridge between the conscious and the unconscious.

Boundaries


We all have both psychological and physical boundaries. Our protective shell (or
 protective way of operating within the world) and our boundaries are learnt in 
several ways; firstly by healthy modelling from our parents, who would have
 healthy boundaries, perhaps around their own sexuality, who they had in the house,
 when they did certain things, how they expressed emotion, how they were with you
 physically etc. So healthy modelling by your parents is one way of learning 
boundaries.

Then, your boundaries are supported by your parents until you are old enough to 
support yourself. Your parents would protect you from outside influences. They 
would care for you appropriately. They would honour your boundaries. If you were 
tired, for example, they would put you to bed. They would not exploit you 
sexually; they would not exploit you emotionally. So your boundaries would be 
supported and honoured by your parents.

We all have internal and external boundaries. We have internal emotional 
boundaries, intellectual boundaries, spiritual boundaries, and we have external,
 physical boundaries. The function of boundaries is to protect us from adverse 
outside influences, to keep us safe. They reduce harm so we can remain alive and
 aware. They act as containers so we can make choices. We can respond, we can 
think, we won’t be swamped by others’ ideas, etc. And they help us screen things, 
and make healthy choices around our boundaries.

Trauma


Where there is trauma, you can be pretty sure that there is boundary violation. 
There are different sorts of trauma. If you fall off your bike and cut your knee, your 
physical body has been hurt. That could be seen as a violation of your protective 
boundary. If you’ve been sexually assaulted, obviously your boundary has been stripped and you’ve been violated. When you have a shock, what comes into play 
is the ‘flight/fight’ mechanism, where you would feel alert you’d evaluate the
 situation and then perhaps make some protective action, or it that weren’t possible
 you’d freeze and go into passive resistance or non-action. It the usual flight/fight 
mechanism can’t work when you’re being attacked by somebody and you freeze,
 very often you dissociate and then, whatever happens to you, the pain and the hurt 
can get held in the body. Maybe it is only later, in therapy, that trauma can be
 worked through and the discharge can occur through the body. It is the body that’s 
been violated and it’s the body that needs to be brought to recovering and healing.

The Language of the Body


You can work to create and redefine healthy boundaries through using touch. The 
body is the crucible, the absolute starting point and ending point of all your 
emotional experiences. From day one, you’ve never not had a body. You’ve always 
been in your body and it’s a filter for your existence. Touch is the first language. 
It is the language of the body. You learned about such important things as bonding 
with your mother; you learned about your needs – whether your needs were met,
 whether you were picked up and cuddled and fed; or that were not met – you were 
left screaming when hungry, your nappy wasn’t changed and all this kind of stuff.
 You learned about separation, when the person that cared for you put you down or 
left you. You learn about all things through the body. Perhaps you were subjected
 to physical abuse or sexual abuse or some kind of neglect that happened through 
the body. What happened at a very early age was simply sensation, preverbal, just
 feeling something, it was the sensation that was there in the body that left an
 imprint in there. The more severe the trauma, the deeper the psychological 
imprint.

Very often you’ll find in traditional psychotherapy a kind of a touch taboo. Many
 analysts of one kind or another would never think of touching their patients,
 because of a lot of sexual connotations, or fear and anxiety around the fact that 
touch enhances the feelings of sexuality between the client and therapist, and also 
that touch can stimulate the original trauma. One has to be aware of what’s going 
on both at a physical and psychological level around touching within a therapeutic
 context. There is perhaps a feeling there that if you’re working with someone 
who’s been sexually abused or is a survivor of sexual abuse, you could reinforce
 their lack of boundaries. You could make them feel disempowered and generally
 reinforce the negative issues that were there. But it’s very very important to 
realise that touch can be very effective in creating healthy boundaries. We need to
 learn to create boundaries through the body and through touch.

The issue really is not: ‘Should we touch?’ but: ‘How can I touch this person?’
 That is a powerful statement. How can I touch, how can I reach this person? As I
 said earlier, touch is reciprocal. There is always a sense of another. It begs a
 relationship and it’s this reciprocity that makes touch very controversial within the 
therapeutic context. As therapists we learned about clients’ issues being projected on the therapist, the whole area of transference, and therapists’ issues being
 projected on the client, countertransference and touch is a powerful way of 
reinforcing these. So can touch bring up sexual feeling between the client and the 
therapist? Of course it can, naturally it can, it can touch on all sorts of emotional
 feelings. The point is that touch does not just evoke sexual feelings, it is about a 
whole range of emotional feelings. The main concern here should be how to work 
successfully and skilfully with these feelings that are brought up through touch, not 
to avoid touch because it brings up feelings.


Sexual Abuse and Touch


If you have been sexually abused, you have been “mistouched”, you’ve been
 touched in a violating fashion. Your boundaries have been violated and you had no 
say in the matter, you’ve been at somebody else’s mercy. Perhaps you were very 
young, perhaps it was threatening, perhaps even life-threatening. So there was 
simply nothing you could do, apart from allow this situation to happen. You had to 
be passive, you were small, the perpetrator was big. Perhaps you’ve been frozen 
by this traumatic experience and sexual abuse has meant your body has been taken 
over by another person. You need to repossess your body. This is not an 
intellectual process. It is a bodily feeling process and feelings are always
 experienced through the body. Touch is the language of the body. Sensation and 
feeling is the language of the body. Your feelings come first and then the
 interpretation of your feelings. The bodily sensation comes first. That’s why
 when you are working with abuse (something that happened to the body),
 counselling is only half the story and half the solution. The body has been the
 object and instrument of abuse and you have to address that, you have to consider 
the body in that healing. It is so important that therapists and psychotherapists 
understand the importance of this of this when working with emotions and
 psychological experience. Everything happens through the body.

Victims of sexual abuse often have issues around guilt, shame and confusion,
 which can lead in turn to low self-esteem, poor self-image, all the messages that
 your body has taken on from the abuse. So you are out of control; you’re helpless, 
you’re powerless, etc. People can become locked in this at this stage. They can 
become promiscuous, self mutilating, destructive, suffer eating problems, become
 compulsive – all kinds of things. These are body based consequences of abuse;
 their body has betrayed them, the body is not a friend. It has become the enemy, it 
has become a source of pain, of weakness, etc.

So how to deal with this through touch? Touch has not been safe, it has been 
threatening, perhaps painful, it has been forced upon them. When you’re working 
with somebody who has been abused, it is important to help recreate safety and 
security and trust. If these things don’t exist, the therapy is going nowhere. If your 
client doesn’t feel safe with you, if they’re on guard, they are never going to let
 down their defences, they are never really going to tell you, they’re never really
 going to open their heart.

Unless there is this sense of safety this is simply felt. Here is some body who has
 not been safe. They have no possibility of being assertive, no possibility of being 
in control. As a therapist, you don’t know what’s right for somebody else, they are 
the expert on their own body.

I remember working with somebody who was very sexually abused and I
 remember making a cardinal mistake with her. When we were talking about touch,
 she said she wanted a massage and it would be the healing part of her therapy. I
 asked her how she wanted me to touch her, and she went into total panic, she didn’t 
know what to say. She just freaked out and looked shocked. I wasn’t touching her,
 we were simply sitting, talking about touch, and I realised she did not know what 
to say. She had no emotional vocabulary of any gentle or soft touch. She had no
 context for that. So I changed my question. I asked her, how should I not touch
 you? Then it came flooding out. “I don’t want you to touch me harshly, I don’t
want you to touch me forcefully, I don’t want you to touch me roughly.” It was
 powerful for her to say that. She really cried. She was expressing how she did not
 want to be touched. That opened up a whole other area of exploration. We worked 
for a long time to find her voice saying how she did not want to be touched. And 
then through that I found how to work the opposite way to what she said. I found 
a way of working gently and respectfully, but the whole time she was in control,
 she had the control. I handed it over completely to her. I was her slave in that 
moment. If she wanted me to hold her toe for a half-hour, I would do that. If she 
wanted me to sit at the other side of the room, if she wanted me to simply stroke 
her hand that would be fine. We started to build up shades and variations of colours
 of touch that were appropriate and healing for her, that she could take in.

When I started training, I remember being in groups where everybody was 
hugging each other indiscriminately, and I learnt the value of holding back.
 Hugging can be appropriate, it can be powerful, it can be a comfort. It can be all 
sorts of things. It also can be contraindicated, it can be rushing in to help 
somebody when maybe they should be left to deal with their feelings. It can be a
 gross invasion of someone else’s privacy. It may be swamping that person. You 
may be hugging from a very innocent point of view and another person might see 
it as a sexual come on. You don’t know what people’s references are in terms of 
touch. If you are used to touch, it can become a very positive, useful language.
 Those who are not used to touch may only see it in a sexual context, and then you
 can get into all kinds of confusion.

The starting point should be one of clarity where your client takes control. It’s
 important, I think, for therapists to do work on this themselves in this area, to be
 working in supervision groups and to be working in pairs, doing exercises yourself. 
Looking back on your own history of touch: Who was touched? How were you
 touched? What happens when you’re touched? These are very big questions.

[Judith Ashton runs workshops (The Healing Touch) and training courses in
 massage therapy in Bennetsbridge, Co Kilkenny. This article is edited from a 
lecture.]


Bibliography

Ashely, Montague: Touching – the Significance of the Human Skin

Clyde, Ford: Compassionate Touch.