To hug or not to hug

Yesterday one of my students asked me a question, one that is asked often, one that I asked my professors not too long ago. Is it ok to hug your patients. He said that he has asked this before of other professors, but my being in active practice, he wondered if I had different views on this.

This can be somewhat complex. You open a persons mind up in therapy, raw emotions are oozing out, you turn them inside out, revisit painful experiences, their inner self is exposed for judgement. You emphasise, you feel their emotions, you often will revisit the painful experience with them…. it is instinct to hug. 

but…

 

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You may find when a hug is offered, your patient may recoil, withdraw, they do not want to be touched. Even when raw emotions are just barely hidden below the surface, they may not wish to be touched, perhaps this is why they are sitting in this room with you, because they were once touched… Touch for some disorders is very unwelcome, OCD as a prime example, whilst with other disorders, contact is very comforting, those that suffer with BPD will often feel great benefit from hugs.

Offering hugs with each therapy session can lead to a diminishing effect, the hugs will begin to mean less and less, or attachment issues may develop. 

Touching, is something that in a professional relationship, is not always proper. Sexual undertones often emerge. A hand touch during therapy can be grounding, but it can also trigger a patient.

Connotations are often perceived, there could be feelings of sexual undertones, your patient may feel something from you that is not there. They may feel that you are feeling this way toward them, this can bring on a very uncomfortable relationship.

When, during a session a patient is perhaps a quivering mass and seeks a hug, withdrawing from that hug can be damaging.

There are times, when you know that a session is going to go deeply, to expose emotions, before starting, it is not so hard to talk to your patient, to tell them this, to ask if a patient if a hug is an upsetting thing for them. this is good to know at any rate. If touching their hand during a session is something that would trigger them, or upset them, or help them relax.

A patient may really need a hug during or at a sessions end. To ask though, is often something that is very difficult for them. Sometimes to ask for a hug demeans it. An open conversation about hugs or hand touching before a session, or at one of the first sessions, a conversation that should also be revisited, is very wise. Setting boundaries, so there is no misinformation, no assumption, no wondering, no pressure.

When setting boundaries, you can establish that there will be no hug unless requested, but then the patient may feel that, because they are not comfortable with a hug, but feel you are waiting for one, that you begin to judge them, because a hug has not been requested. Pressure evolves in the patient to hug, even if they may not wish to.

Just because you as a therapist feel the urge to comfort, the urge to hug, it may not be what the patient wants or is comfortable with. Crossing established boundaries must not be done by the therapist.

Some people are not comfortable with hugs, some give poor hugs as a result. When a patient asks for a hug and a poor hug is offered, this can damage the relationship, the trust that has been built up.

When establishing boundaries, a patient may tell you that a hug or a touch does not bother them, but then a patient does not always say what they truly feel.  Perhaps they tell you what they think you want them to say.

If a hand touch evokes withdrawal, this should be discussed. Do not send your patient away feeling uncomfortable.

It is advised to avoid physical contact with a patient, this does not always apply though, so when is it ok?

 I gave my student the same answer that I received when I asked my professor. “Amber, you will know when it is right”.

 

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About sensuousamberville

I am a Practitioner, teacher and student. I think we should always be students, we should keep our minds open, to continue to learn. :-)

9 responses »

  1. Given all of the pros and cons you listed, I like your approach and the answer your prof gave is very apropos as well. 🙂

    Reply
  2. I got a hug from a psychologist when I was fifteen after she had to call my mother in to tell her something. I got another hug from a different therapist when she had to leave. Apart from those hugs I don’t think there have been any others but there have been times I have wished for a hug or some kind of comfort.

    Reply
  3. In a professional setting like this, I would say it’s better to stay away from the hugs, even conversations about them Just as you wrote, someone might agree to a hug because they feel that’s what the Therapist wants. A Therapist might feel a hug is appropriate for a special reason, but I’m not so sure if I’d appreciate it at any time

    Reply
    • Often a hug is what the therapist wants or feels a strong need for Cat, Then a hug is wrong, as it is not about the therapist. Other times though, it can be a helpful part of therapy. I like to talk about it with a patient, because it often brings forth other issues about touch.

      So in the conversation about them, it has to be made clear, that there is no pressure for the patient to wish to hug if they do not wish to, They will not be judged one way or another. Often having something for them to hug helps, a large stuffed animal, that they can squeeze, or a pillow. Sometimes a smile is all someone needs.

      Reply
  4. I try always to appreciate people’s personal space and trust my intuition. Some people are very open to hugs, others not so much. I have a very good friend who does not like to be touched, and another friend who has an aversion to hugs (I suspect a past trauma comes into play).

    Reply
    • Sometimes it is intuition. But asking do you need a hug, often works too. In these cases, past trauma is often a big consideration.

      Welcome to blogging. 🙂 I loved your first post.

      Reply
      • Thank you so much! I’ve been blogging on other social media for a few years, but this is my first foray into getting more serious about my writing. I registered my domain to set up a wordpress.org blog, but then was told it is easier to start here and then move there later. There seem to be conflicting opinions on that. I’m learning as I go.

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