The Worst, Most Horrific, Yet Sometimes Okay Thing We Do
Posted on September 5, 2014
Sometimes the complexity of our work is demonstrated by our struggles with seemingly simple acts. This post examines one of the most difficult, challenging, and controversial acts associated with healing. In past posts, we have discussed quantum physics, nanotechnology, and brain science, but today we take on the most complex issue of all: Hugs!!
To hug or not to hug?
Let’s first start this examination by admitting that we (helpers as a group) hug each other all the time! Few professions use the hug as a professional greeting, but go to a social service/public health conference and it seems more like a family reunion than a professional gathering. In other words, we seem to have set the norm with each other that hugging is okay between two professionals.
Everything changes when we shift the focus to hugging clients and patients. This natural act of friendship and caring becomes a boundary violation that has the potential to damage the relationship with the client. How can something we do so freely with each other become so dangerous when it is given to a client?
Here are the standard arguments. First, clients with histories of sexual or physical abuse might be triggered or even re-traumatized by the experience. Second, clients might not be able to tell the difference between an act of professional caring and an act of friendship or sexual attraction. Third, it is just not professional, and blurs the line between client and helper.
Three very real and critical arguments. Working with traumatized children in most of my professional positions, these arguments have led me to not hug clients, and to set this as a norm for the staff that have worked in my programs. Even though I have never fully hugged a client, there have been times when I’ve thought, “Man, that kid just needs a hug.”
Sometimes a handshake just seems faked and forced after some of the intense conversations we have with clients, yet the intensity of the moment also can reinforce why a hug might be misinterpreted. So we try to find a compromise by placing a hand on their shoulder, or maybe we get innovative and give the side hug.
The importance of physical touch is so critical for our clients who are often ignored or stigmatized by others in their communities. On one hand, to be touched in a caring way shows belonging and acceptance. On the other hand, distance can be misinterpreted by the client. They may think the helper considers them too dirty or sick to touch. This is clearly reminiscent of the Dalit, or untouchable class, in traditional Indian society.
The need for touch goes back to our evolution. Like chimpanzees, our hairy ancestors groomed each other to create attachment, emotional regulation, and social bonds. Throughout our lives, we embrace those we care about, as the physical closeness embodies our social connections.
For many traumatized clients, physical touch has been absent, or associated with hurt and pain. As a result, a hug for some clients would be healing, whereas for others it might trigger memories of past pain and suffering. Since we first try to do no harm, we often err on the side of limited contact.
I am in no way encouraging you to hug all your clients or patients today, nor am I judging those that do hug clients from time to time. What I think is important is that we pay attention to physical touch and its role in the healing process. Our clients must feel worthy of the changes they are trying to make, and feeling untouchable makes this very difficult.
Professionalized healing is a tricky minefield. What might be the perfect thing for one client may re-traumatize another. The complexity of hugs helps to demonstrate the complexity of holding both the healing and the professional roles. Healing pushes us to cross over into highly personal and intense topics that make the client vulnerable, while professionalism means we must keep some distance as well.
This balance plays out in a million difficult ways in exam rooms, outreach efforts, therapy sessions, home visits, and the many other ways we connect with clients. My question this week is two-fold. First, how have you seen physical touch used appropriately in the healing process? Second, where do you draw the line with physical touch and your position?
By the way…give yourself a big hug today!