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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! 

3 responses to “The Worst, Most Horrific, Yet Sometimes Okay Thing We Do”

  1. Anonymous says:

    I found this artricle very thought provoking

  2. Anonymous says:

    I fined this area difficult but am glad Imp not alone in this one. I do think touch is so powerful.

  3. Colorado Gal says:

    As always Matt, a topic worth discussing.

    When I was a high school counselor, some of my students offered me hugs daily while they walked through the halls to their first class. Others would not make eye contact. Most of them I had a close working relationship with, knew their backgrounds, about their home lives, personal lives and knew their intentions were not malicious. I also shared some personal information with the students, so they knew my intentions were positive and caring. I also knew about some of the students who couldn’t/didn’t make eye contact. Did they need a hug, probably, but was I the right person for that, probably not. It seemed to me that the students who hugged me were the first to broach the subject of “can I get a hug” or “is it okay if I hug you?” It was also a culture at the school, since we started with only the freshman class in a small section of a middle school. We knew their names, their parents, their stuff and many of them knew about us as people outside of school.

    Reading body language at that position was something I needed and used every minute of the work day, not only with students, but with my peer educators as well as parents.

    In my current position in a non-profit organization helping those with chronic illness, hugging is far and few between. We talk to our clients over the phone and never meet them in person, and to me that is both good and sad. Good that we can read their voice and listen more carefully to the words they use. Sad as well, since ALL of them desperately need some type of human touch. Would hugging these callers cross a line of professionalism, I would have to say yes unless we have worked with them consistently for years and created a bond of trust. So many have unresolved emotional issues as adults and hugging to them may not mean the same as a good intended “hello” or “so long I wish you well.” Even with my peers, hugging isn’t as popular as I would think between social workers and counselors. I really hadn’t thought about it much until today when I read your post. I think it has more to do with our level of trust with each other, how our management team looks at us and treats us (poorly), as well as being mostly burnt out. Could we all use a NICE BIG HUG, heck yes!!! But personally, I would rather get that from my family at home or a close friend I have a better connection with outside of work.

    Hugs to all!

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