ten

It has been five months since I’ve posted. Motherhood keeps me busy! Also, analysis five days a week is incredibly complex and so hard to encapsulate and put into words, especially while one is in the thick of it.

But, I am grateful to the author of lifeinabind for bringing up the topic of touch in therapy. It has long, long been a source of both pain and pleasure for me, and I think it should be something that is considered as part of talk therapy far more than it actually is.

I don’t have time to explain or write a full post, but I will edit and take some of my comments that I wrote on lifeinabind’s post to explain my experiences and thoughts on touch in analysis (wow! This ended up being very long!). Also, for anyone who is interested, I will include the list of research articles I found helpful for convincing my analyst to allow touch in our work. (For the most part, it is working wonderfully.)

I feel very passionately about this issue, and I’m happy to answer any questions in the comments!

“I see my analyst five days a week, and I see a “supportive” analyst on Saturdays because I have such a difficult time with the loss of connection over the weekend. It is still not enough, but it is what it is.
I also plan to never be done with analysis. My analyst says that lots of people are in it forever, and I plan to be such a person. One never stops growing or learning.

It’s actually not Freudian, it’s Modern Psychoanalysis (looking up Hyman Spotnitz is a great place to start if you want to learn more). Five times/week isn’t a requirement of modern analysis but it’s important for me in order to keep the connection. It is the most intense, intimate experience I have ever had. Analysis is fascinating.

My analyst would happily let me lie on the couch but the idea makes me nervous. It feels very exposing and somewhat sexual to me. I’ve never done it. I’ve heard that it can make free association more productive as it can remove the pressure of looking at the analyst while talking. Instead, my analyst and I sit on the floor next to each other, with our arms touching. Lately we’ve been sitting with a blanket across our laps. Occasionally she will hold my hand. It’s very warm and wonderful and really helps me relax enough to feel a connection and talk. It took a lot of convincing, though, to get her to try it this way. She was very hesitant (“That is not how analysis is done.”), and I brought in a lot of research on oxytocin and physical contact in analysis in order to support my position. But, I knew what I needed in order to be productive and I think she picked up on that. We’ve been sitting together for about five months [ETA: now eight months] and it’s been working very well.

The focus of my analysis is on the relationship – how to be in one that is healthy and mutually respectful, how to ask for what I need and how to get my needs met by someone besides just my analyst, and working through the transferences. It is chaotic and messy and often overwhelming; it took awhile for both of us to find our footing. My analyst had never worked with someone five days a week, sat on the floor, etc. It is also very, very lovely.

My analyst is 61 and I am 26. Though she says she never plans on retiring, the reality is that one day she will have to stop working, either due to old age or death. I will, at some point, need to enter into another analytic relationship. I plan on being an analyst so it will be important for me to stay in analysis. The thought of losing my analyst, though, is incomprehensible.

I’m a firm believer in the idea that touch in therapy, while not for everyone, could do many people a lot of good.

I should mention that after I first asked my analyst to sit with me and she said no, I accidentally stumbled across alexithymia, which I found to strongly match my experience. Alexithymia is basically a lesser ability to know what one is feeling. My research into that showed that increased oxytocin is helpful in the “treatment” of alexithymia (excuse the quotation marks; I hate labels and diagnoses and such). My argument for contact in my analysis became even stronger with the idea that oxytocin is released in this way.

I emailed a bunch of therapists/analysts who had written about this topic as I was looking to make my case as strong as possible.

Touch is complicated, even when it’s incredibly natural and simple. Tonight my analyst sat with her arm around me and it was wonderful, and then the session was over and I had to leave and go home. It will never fill the hole from childhood, no matter how much I get. I think it is most important to have a meaningful relationship, because it is in the space which the therapist and the client create that change occurs.

(Some background):
I have a history of sexual abuse, and in my family of origin it was unconsciously communicated that it was shameful to have a body, to physically exist, because bodies are only for sex and sex is bad. Touch was seen as sexual so there was very little of it outside of the abuse.

My previous therapist was very affectionate and that is how I grew to be aware of the lack of touch in my life. Before that, touch was incredibly awkward for me and I kind of looked at it with disdain. But then my first therapist decided I “needed some mothering”, zipped up my coat, and I was high on touch. I grew to love her in a maternal way (nothing sexual ever happened) and even though our relationship started to get very rocky, I could never imagine leaving her. I knew that she was in over her head with me, but the touch was too important to lose. Eventually things got so bad that she dragged me around a room and pinned me in a corner when she thought I was suicidal. I had bruises from our squabble and I worked up the courage to leave a few months later. She had been so kind to my body, but ended up hurting it.

Okay, so my analyst – initially I was very wary of her. On our second interview session, I asked if she would try to have sex with me if I decided to lie on the couch. I was sure that no one would ever touch me safely again, that my first therapist had been my one and only chance.

I wasn’t too concerned about erotic feelings. I did once have an overwhelming urge to kiss my first therapist, which I’ve never discussed. Once recently with my analyst, I felt so moved by how much I loved her that I felt that a kiss should follow our hug. I haven’t told her, but I think for me it’s from my history (what isn’t?!), that I grew up thinking that sex is the only way is the only way to be physically intimate with another and when I love someone, I’m supposed to be sexual with them. Logically I know this is not the case and the feeling passed as quickly as it came. My analyst did ask once if I had any sexual feelings about sitting together. I said no, and she said it was okay if I ever did, that she wouldn’t freak out and we would just talk about them and not act.

So, my feelings for her were initially complicated in a different way – I was worried she would hurt my body like so many other people had, and then I was desperate for her to touch me and she wouldn’t, which brought up feelings around my mother. Now she does touch me, but she’s mentioned that she isn’t a naturally physically intimate person, so I often want more than I’m brave enough to ask her for, because I desperately want to preserve the relationship and I don’t want to drive her away with my neediness. And more than anything, I want to go to her house and curl up in her bed with her and sleep. It is frustrating that I can’t get what I want/need. The feeling toward her is always maternal and that is how I interpret her touch.

I absolutely, 100% trust my analyst to not cross a sexual boundary. I have spent many hours in her office alone with her, and if she wanted to do something, she could have.

Erotic feelings – though very real – are maybe not so worrisome. They are feelings like any other, and they warrant a good discussion. They don’t require action, and should the feelings arise, it’s likely one would be able to prevent any action from occurring.

So, as I said earlier, my analyst was absolutely against touch in analysis. The feelings of rejection and abandonment from my mom were so strong that I had literal freak outs when my analyst would say no. I mean, full on meltdowns, hyperventilating, dissociations, you name it. When I left my therapist, I thought I was ready to give up the physical contact – boy, was I wrong! And now I was in a situation: stay with my analyst and accept her position, stay with my analyst and hope that she changed her mind, go back to my therapist, or go find someone completely new.

So, there was a lot of discussion. A lot. I brought in all of my research. We talked theory. We talked about needs. She said that I might not deal with the feelings of abandonment if I didn’t face them in my therapy. I countered that obviously she wasn’t going to sexually abuse me, and I wasn’t going to have to relive that to process it, so why did I have to relive something else that was traumatic? Lots and lots of discussion.

Of course, she consulted with other analysts, which I fully encouraged. Her supervisor was supportive of my position, someone else was completely against it, and a third person was on the fence. The person who was against it suggested analytic reading material for me which ended up pissing me off. It was all about how talking in analysis is important, etc., etc. I said that of course I wanted to talk – that was what the touch was going to help with! Without touch, it felt like a very formal business meeting or an interview, and I didn’t see how I would be able to work productively in that mode. (The guy’s literature also pointed me to alexithymia, so I admit there was some benefit.)

My analyst continued to say no and so we tried to come up with ways to eliminate the formal feeling. We started by sitting across from one another on the floor. It didn’t really help and it was even more frustrating. With our legs extended, we could have touched each other’s foot and that was not allowed. It was just… haha, I don’t know. I had to be very patient. Looking back, it set a very good foundation for our ability to discuss our relationship.

Anyway, my analyst held firm and while she was very compassionate and kind about the pain I was experiencing, I told her that I didn’t know if I was going to be able to stay if we weren’t able to touch. She understood and said that while it could happen down the road, it wasn’t going to happen now.

So it was really the alexithymia that did it, I think, plus our many, many sessions of discussion. As I mentioned before, in my research I found that alexithymia responds to oxytocin, and oxytocin is obviously released when there is human contact. After that, things kind of changed and we eventually sat down together to write a contract. It was supposed to be a trial and if it didn’t go well, my analyst said she might have to refer me on to someone else. It was kind of a scary leap but I didn’t know where else to go with it. The contract stated that we had discussed and researched the topic. It said that we would sit together on the floor in order to help me talk and for a therapeutic alliance to form. Either party could terminate at any time. As touch in therapy can be taken as sexual, and given my history, it was very, very important to me that our arrangement was not kept secret. And of course it wouldn’t be, as my analyst discussed my case with her supervisor, but I wanted it in writing. And my husband was made aware of the situation. I just wanted people to know so it wasn’t this “dirty secret”, even if it wasn’t dirty. Touch in analysis is obviously not common. My other big concern was that we had been dealing with this issue for so long and it had been so stressful that I was unsure of whether or not I would be able to work with my analyst based on the fact that I had had to struggle so much to get her to try what I knew I needed.

So, we signed the contract and then we sat together and it was weird at first. And there was a lot of stuff to work out, like when I wanted to hug her and she wasn’t comfortable with it, or how I felt she was distancing herself from me if we were sitting very close but not actually touching – you know, just, I don’t know. Details and such. We did A LOT of checking in. I would ask her how she felt, she would ask me how I felt. She would see if the contact was too much, not enough? I was worried about forcing her to do something physically that she wasn’t comfortable with (because it made me feel like I was being abusive in some way), and to this day I ask her at the beginning of every session if I may sit next to her. We’ve been sitting together for about eight months now and it really is working beautifully, but we talk about it now and then. I always want to make sure she is comfortable. Additionally, she has gotten to know me in that way and has held my hand or put her arm around me a few times when our discussion has gotten particularly difficult. And I always, always get a hug on Fridays before the weekend.

So, I think it’s good to keep talking because one might have feelings about something initially and then one’s feelings can change or evolve, and same with the therapist. It’s a good rule for any relationship, I think, whether there is touch or not. Checking in with a person you’re in relationship with is a great resource because it helps you to know what’s going on.

I think it took about 4-6 weeks of constant discussion (and I was doing 5x/week analysis) for my analyst to feel comfortable trying it. It felt like a very, very long time.

As far as boundaries, my analyst said she wouldn’t want anyone to sit in her lap or anything, and that was fine with me. I’ve mentioned how I’ve wanted a hug or something and she’s been hesitant, as she was raised in a way where you don’t just hug people you don’t know well. In the past month or so she has seemed to be more comfortable with hugs and I’m taking it as a sign that she has come to know me better. There are still the rules of the contract but they don’t really feel like rules, they feel like a very clear understanding of what each other is comfortable with and a mutual respect to uphold those standards as to keep the relationship respectful. I would never want to make her uncomfortable, nor would she want to do that to me. It’s just kind of… easy, now, I guess.

As can probably be surmised, touch absolutely did not come about organically, at least in the beginning. Every now and then my analyst will reach out to me when she knows I need it, and that has been really nice. But at first it was awkward and a little forced. She knew that I knew what I needed but felt out of her element and it was a navigation on both of our parts. It’s always difficult for me to ask for something because of my worry of making her uncomfortable and being too needy. Like I have this fantasy that some Monday I will go in her office and sit down next to her and ask her if we can hug under the blanket for a few minutes so I can just BE with her, because weekends are so difficult. But I have yet to work up the courage to ask for that.

I told my analyst that if this works out, she should publish an article. I think it’s kind of a unique way of working and it has definitely helped me and if it could help someone else, then all the better.

https://books.google.com/books?id=Pp-ajrfMDOwC&pg=PA327&lpg=PA327&dq=physical+touch+in+psychoanalysis&source=bl&ots=EQmQA1aygB&sig=GqcymLanAX2CWrGpJohL4mAW098&hl=en&sa=X&ei=t9ttVZL-AYjQtQXhi4G4Ag&ved=0CC4Q6AEwAg#v=onepage&q&f=false

http://icpla.edu/wp-content/uploads/2012/09/Breckenridge-K-2000-Physical-Touch-in-Psychoanalysis-A-Closet-Phenomenon-Psychoanal.-Inq-202-20.pdf

http://www.cbpc.org.uk/TouchInPsychotherapy.htm

http://www.zurinstitute.com/touchintherapy.html

http://www.psychotherapyexcellence.com/read/read-listing/2012/november/touch

http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&uid=2001-16100-003

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832802/

http://www.psychoanalysis.ugent.be/pages/nl/artikels/artikels%20Stijn%20Vanheule/In%20search%20of.pdf

http://www.academia.edu/1080285/Affectionate_experience_mediates_the_effects_of_alexithymia_on_mental_health_and_interpersonal_relationships

http://www.cbpc.org.uk/TouchInPsychotherapy.htm

Fosshage, J. (2000)
The meanings of touch in psychoanalysis: A time for reassessment.
Psychoanalytic Inquiry. Vol. 20, 1: 21-43

Speaking of feelings: Affect, language, and psychoanalysis. Published in Psychoanalytic Dialogues 8: 685-705, 1998

http://apa.sagepub.com/content/61/1/99

 

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4 comments
  1. So glad you posted this and thank you again for both helping to make this a topic of discussion in my own therapy and also for your willingness to share so much of your own thoughts and story and also the reading material yoy found. You are definitely passionate about this, and rightly, it is obviously working really well for you 🙂

  2. Lou said:

    I am not new to the topic of “touch in therapy”. I have had hugs from my therapist for about three years (maybe every three months if I ask for them). They really do make me feel more accepted/cared about and less shame based.
    I have replied to the “Life in a bind – BPD and me” blog this morning also and am really tired (3:44 am here) but wanted to thank you for this blog also!!!
    Your experience and writing about them here is so confirming of how I have felt and continue to feel (internal dialogue very similar) about touch and therapy in general.
    Thank you!!

  3. Reblogged this on Life in a Bind – BPD and me and commented:
    I am very grateful to ‘how to be an analyst’ for originally raising the subject of touch in psychotherapy with me, in a series of comments on one of my blog posts. I am also grateful for the excellent reading list suggestions! Ever since that time, a few months ago, I have been thinking, reading, and talking to my therapist about it. I have also been meaning to write about it, and am grateful to ‘Lou’ for her email on the subject, which raised it for me yet again, and led to me writing a recent post about the desire for touch, which will be followed by another post on feeling ‘untouchable’. This post from ‘how to be an analyst’ draws together her very helpful and informative comments on that initial blog post, that sparked my interest. I am very thankful and appreciative for the time that she spent writing those comments, and for her honesty and courage in speaking about her own past experience and also her struggles in therapy. I very much hope that this post will be as interesting and helpful for others as it was for me, irrespective of their views on the subject. Touch is not part of my own therapy experience, but it has been very valuable to think about it, talk about it, and try and understand the views of those who advocate it, and those who are hesitant…

  4. Lou said:

    Such a profound feeling to know your comments actually “resonate” with others. I feel very fortunate to have happened upon this subject online and in my therapeutic process.
    I see my therapist tomorrow and have a long list of questions for her to answer to help me feel somehow less “bad” due to her decision. I believe it is a work in progress that will take some time and consistent caring on her part but it should work out and will probably be a very important learning opportunity for both.
    Thank you once again…

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