Dialogues on Touch in the Psychoanalytic Space
Graeme Galton (Ed), 2006 London:Karnac Books
pp177 £24.99 (paperback)
John Andrew Miller
Touch Papers: Dialogues on Touch in the Psychoanalytic Space comprises twelve essays in which various authors reflect on aspects of physical contact in therapeutic relationships. Most of the authors are Freudian psychoanalysts, although a Jungian analyst, a body psychotherapist, and a child therapist make their contributions, as do a group of forensic therapists who jointly write about their work in a secure prison setting. Their different ideas make this volume an important book, one that needs to be read and discussed, as psychodynamic practitioners look at this important issue.
The book begins with ‘Too hot to touch?’ a 6-page Foreword by Susie Orbach. Orbach considers psychoanalysis’s difficulty in embracing ideas that challenge perceived wisdom, of which ‘no touch’ is a key one. She then talks about the need to re-think the taboo on touch in terms of changing concepts of relating and in terms of research findings on the therapeutic impact of touch. She concludes that:
‘… psychoanalytic clinicians may need to gather and reflect on our own desire to touch, our fear of touching, or responses when asked to touch, our responses to being touched or wanting to … so that if we do indeed continue with the taboo on touch we know why we do so. We do it mindfully rather than canonically’ (p. xviii).
In the Introduction, the editor Graeme Galton, discusses the paucity of touch in psychoanalytic writing on touch in the consulting room, then how the book came to be compiled as a way of amending that lack, and concludes with a brief paragraph about each paper.
The twelve pieces, the ‘dialogues’ which follow, represent a wide spectrum of positions and a wealth of clinical experience. I particularly liked Valerie Sinason’s ‘No touch please – We’re British psychodynamic practitioners’ in which she explores with humour and compassion her own effective use of limited touch with some patients; and Nick Totton’s ‘A body psychotherapist’s approach to touch’ which well articulates the inner questions that many therapists with both body therapy and psychoanalytic backgrounds strive to answer about the ‘who’, ‘when’, ‘why’ and ‘how’ of using or allowing touch. A.H. Brafman in ‘Touching and affective closeness’ and Camilla Bosanquet in ‘Symbolic understanding of tactile communication in psychotherapy’ both stimulated an internal dialogue about how therapists practice differently from one another and how much patients vary; these two essays were worth reading. However, I found that Robert Langs’s essay on ‘Strong adaptive perspectives on patient-therapist physical contact’ seemed to be very prescriptive and authoritarian. Brett Kahr provides an interesting, but surprisingly conservative discussion of Winnicott’s use of touch.
Other essays in Touch Papers include the initiating reflections of the editor Graeme Galton as he struggled with ‘Bearing witness to an abused patient’s physical injuries’, a very moving piece that explores the helpfulness and the dilemma of allowing touch. Pearl King emphasizes how touch, if it occurs, can become an important discussion point. Em Farrell, once a body psychotherapist and now a psychoanalytic psychotherapist, discusses the importance of being aware of two bodies in the consulting room. Maria Emila Pozzi talks about her work with children. Nicola Diamond writes well about the hidden meanings of touch and its potential as a means of communication. The five forensic psychotherapists – Emma Ramsden, Angela Pryor, Sarita Bose, Sharmilla Charles, and Gwen Adshead – complete the picture, writing about their work in prison settings where touch has a past history of abuse and violence and a potential history of contact and love.
Something seems to be missing from this book. Upon re-reading the title, it occurred to me that there is actually no dialogue in the Dialogues on Touch in the Psychoanalytic Space. A final concluding section which draws from the different strands might well have made this book more alive, exciting, and ultimately more helpful.
Also missing is an actual definition of touch; none is really provided, and the subject is left vague like the title, Touch Papers. Different authors individually define touch, and everything seems to be included – from accidental contact, to shaking hands, to one case of fellatio – but few writers seem to focus on what they and their colleagues might agree constituted touch, especially therapeutically useful touch. I would have liked to see an essay concerning the two points that Orbach mentions in her Foreword, not taken up elsewhere: the therapist’s fear of touching and the profession’s need to incorporate modern research on the importance of touch and reconsider, if not actually modify, technique and practice.
The most striking thing to emerge out of Touch Papers is the disparity between what is done in sessions and what might be acknowledged openly: apparently many esteemed practitioners allow or initiate contact with patients, but would never discuss this with colleagues, students, or supervisors.
In the end, this book does what it sets out to do: it provides a space to re-think a century-old taboo. Touch Papers: Dialogues on Touch in the Psychoanalytic Space does not contain a debate between its contributors, but this volume stimulates an internal dialogue in the reader who wants to open up an internal space recognising the importance of, and the difficulties inherent in, touch within the consulting room.
This review was first published in Psychodynamic Practice 15(2) May 2009 pp208 – 210
John Andrew Miller PhD is a Certified Bioenergetic Therapist and member of the International Institute for Bioenergetic Analysis since 1988. He is registered as a psychoanalytic psychodynamic and integrative therapist with the United Kingdom Council for Psychotherapy and is actively involved in the International Attachment Network [London]. He maintains a private practice in North London for individual psychotherapy and supervision, serves as moderator for three psychotherapy training organizations, and provides bioenergetic workshops upon request.