The Rev. Dr. Glenn A. Robitaille on thinking before you touch

Boundaries and Touch in Pastoral Interventions

Bonnie is a 54-year-old mother whose son recently committed suicide. She presented as labile, confused, and filled with guilt over failed opportunities to rescue her son from the clutches of his demanding and punitive father. With some gentle prodding, she began to unpack the failures of the last decade that saw her leave her abusive husband and return to Canada, leaving her two children behind with him in the United States. Her reasons for making this decision seemed sound at the time but, with the benefit of hindsight, she was face to face with the possibility that she secured her own peace at the expense of the life of her son. Nursing staff, psychiatrists, social workers and the entire multidisciplinary team all affirmed that, given the details of her circumstance, she had little choice but the one she made; but that was little consolation now that her son was dead.

Clinicians have long argued about the appropriateness of touch as part of therapeutic intervention. The impulse to comfort a grieving mother with a hug is instinctive for many pastoral professionals and, at times, may be the right therapeutic response. What would you do if you were interviewing Bonnie?

What clinicians must understand in providing such responses is that touch changes the intervention. Depending on the needs, perspectives and personality of the subject, it could change the relationship in a variety of ways. For some it could evoke resistance. Not all people are comfortable with touch, and something as simple as a pat on the shoulder could shut down an individual who is protective of his or her personal space, or could be interpreted as condescending. Individuals who have experienced physical violations may be distracted from the work you are trying to do with them. They may wonder what you are trying to accomplish by touching them. Are you trying to gain power in the relationship? Are you attracted to them? Or are you simply a caring person expressing genuine compassion? Conversely, personality-disordered individuals often manipulate normal human emotion to blur boundaries and create unhealthy dependence on others. Is the subject truly in need of touch, or is he/she angling to be rescued and vulnerable to forming an unhealthy attachment.

At the same time, touch can be a powerful way to bridge isolation and to communicate warmth. How does one determine when touch is therapeutic and when it is not? I have found two principles to be helpful.

First, knowledge always precedes praxis where touch is concerned. Reflex responses based on our own preferences and projections reflect our needs and not those of our subject. If we do not spend the appropriate time collecting data and assessing it, we are left with assumption and guess work. The time we spend communicating through sensitive questions, mirroring, and restating, builds a foundation of trust. Hurting people need to know that we are hearing what they are saying and that we are willing to listen.

Secondly, good boundary recognition must be evident. Subjects who press boundaries or who lack appropriate boundary awareness are never candidates for touch. The risk of changing the focus of the intervention is too high in such cases. At all times, pastoral professionals must protect their roles as spiritual care providers as primary. Before we shift the relationship to a new level of intimacy, it is important that we insure that this primary function is not compromised.

Do you have thoughts about education & research you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.