You Touch Your Clients?! (Why I Use Touch-Based Therapy)

It's true! I touch my clients. In fact, I'm basically a risk management person's nightmare. *

I cuddle my clients, rock them, cradle them, hold them and hug them. I lotion their tiny hands, I count their toes, I give massages, I play handclap games, I lay on my back and put them on my knees in that crazy airplane/superhero game that some genius-of-a-parent created. I stare deeply into their perfect eyes and sing lullabies. And I coach parents to do these same healing, nurturing and fun activities with their kids in ways their children can't resist. Now why on earth would I do these things?

For the cases I choose to use touch-based therapy, I would argue that NOT using touch in therapy would be clinically ineffective and just plain silly, if not totally negligent.

In cases where touch-based therapy is appropriate, the child's emotional age is not the same as their chronological age. This is often the case with kids who have developmental delays, Autism, a history of trauma, severe anxiety, or attachment issues. Kids who have delays or deficits in the areas of attention, emotional regulation, impulse control, self-awareness, sensory integration, and social skills all benefit from this type of playful, physical therapy that (yes!) includes touch.

So how can you tell if a child's emotional age is not the same as their chronological age? Mostly, you can see through the child's behavior. Does she act like a 9-year-old? Or most of the time, does she appear to have the emotional dependency of an infant, the defiance of a 2-year-old, and/or the social skills of a 4-year-old? Many times, for kids with a history of adoption, trauma or neglect. or for kids with developmental delays, their emotional age might still be very, very young. This doesn't necessarily indicate delays in intelligence or physical agility. I've met young gymnasts with genius IQs who still have gaping emotional delays. 

Us therapists are always talking about "meeting the client where she is." I work to meet my child clients where they are on an emotional level. If we think of a baby, when they are crying, do we sit back and say "It's okay honey, just breathe deeply and don't forget to use your coping skills" or "Hey, if you get your act together we can go get ice cream later"? What about using a time-out or ignoring the crying to get the baby to stop? No, of course not! That would be ridiculous, and if these were the parent's only strategies with a crying infant, it would 1. Not work, 2. Emotionally damage the child, who still feels alone and now perhaps unloved, and 3. Frustrate the heck out of the parent.

With a crying infant, we pick them up, we rock them, we hold them, we cradle and hug and cuddle them, we stare deeply into their eyes and sing lullabies. (Sensing a pattern here?) This is how the parent emotionally "co-regulates" the developing child.

Infants are born with absolutely no ability to self-soothe. They internalize the parent's co-regulation and learn to calm themselves down after the parent has successfully done this with their child thousands or millions of times. Usually, this is a beautiful, natural process; but it can be disrupted when the baby suffers from neglect, abuse, orphanage experiences, inconsistent caregiving, painful medical procedures, prematurity or developmental delays. When these disruptions in development occur, co-regulation can become a very tricky, frustrating and exhausting experience for parents. This translates into a ton of horrible tantrums and melt-downs and absolute refusal to sleep or eat. I feel for these parents.

Okay, cuddling and singing sounds harmless. But how does all this fun stuff count as therapy? Isn't that just playing around?

Can't parents just do that at home? Well. it is playing around, and it is therapy, and it heals children in profound ways. There is a lot of amazing research and science behind what I do. I don't want to bore you guys with facts and figures, but if you're interested, check this out. And yes! I hope that all parents are doing these things with their kids at home. Sometimes, though, parents need support in creating these fun experiences in ways their kids can tolerate and enjoy.

Even though the games are so simple, like peek-boo, for instance, the process of how we play the games is complex and multifaceted.

Yes, we are playing a hand-clap game, but is the child blinking when she crosses her midline, indicating an issue with bi-lateralization? Is she struggling with the simple movements and staring only at her own hands, suggesting trouble with motor planning, or perhaps severe anxiety, perfectionism and fear of failure? What does the child's life story tell us about how she is playing today? How can we shift her view of relationships and the world? In a therapy session, I might ask a parent to "simply" rock and sing to their child, but does the child avoid the parent's eye contact, become very stiff and withdrawn, or seem to squirm against the parent's loving touch? Does this mean the child is avoiding relational connection out of fear, because of a past trauma? Does this mean he is having trouble integrating the quality of the parent's touch or the volume of the singing? Maybe the rocking is overstimulating to his fragile vestibular system? How do we work to slowly help this unique child feel safe and integrate this important relational and sensory experience as something fun, enjoyable, and interesting? What modifications can we make to increase the child's sense of felt safety? This is the real work. When I use touch-based therapy, I am working through doing, not through "talking about doing." 

I partner with parents in therapy to build new neural pathways in their child's brain right in the here-and-now.

We work to offer your child new, healthier possibilities of how to experience relationships and the world- through experiencing it firsthand! We work in a way that honors the child's emotional needs and level of development, and helps her heal in a deep and sustainable way. We work to help the child feel safe, lovable, connected and strong, and carry those feelings with her into a healthy adolescence and adulthood. 

And THAT'S why I touch my clients!



*To learn more about how touch is viewed within our culture, read "Our Unhealthy, Touch-Averse Culture"