Holding Therapies – Are They Effective?

cranial_sacral_1Following up on last week’s blog post on the different schools of thought about attachment therapy, I’ve done more research into holding therapies. Much of what I’ve read and heard about them is negative, but I’ve also had some positive feedback. In this post I wanted to set predispositions aside for a balanced view of the subject with my usual disclaimer that I come at this as a curious layperson, not a mental health professional.

Like most people, I began my research by Googling “holding therapy.” The results were not positive. In fact, it was hard to find an article supportive of the practice. Here is a sampling of what I found in my search results. Again, I haven’t vetted any of these sites or authors, but the consistently negative tone of each result is telling.

On the site, naturalchild.org, Ms. Jan Hunt wrote an article called The Dangers of Holding Therapy. She notes that holding therapy is recommended in the book Holding Time, by Dr. Martha Welch (I’ll get to her later.) It consists of forced holding by a therapist or parent until the child stops resisting or until a fixed time period has elapsed; sometimes the child is not released until there is eye contact.

She considers this practice to be completely at odds with attachment parenting, which is above all a relationship based on mutual trust. It can be immensely difficult for a child to regain full, genuine trust after being forcibly held – regardless of the parent’s “good intentions” or the resulting surface behavior.

Even if there were an emotional “breakthrough”, it would be at a great hidden cost, as there is no way to avoid the child’s feelings of anger, frustration, resentment, and betrayal. Like spanking and all other forms of punishment, the child may appear to comply, while his deeper feelings become submerged until they can be more freely expressed. Further, where force is used, the authenticity of any “success” is forever in doubt.

As an alternative, Ms. Hunt suggests meeting the child’s legitimate needs (undivided attention, food, sleep, attention to hidden allergies, relief of family stress factors, etc.) Where force is simply unavoidable (the proverbial child running into a street), it should be kept to the barest minimum possible, and followed by gentle explanations and apologies.

On the site, bigthink.com, there was an article titled, Holding Therapy: Blowing The Whistle on Institutionalized Child Abuse in the UK. The article begins by stating that a “bizarre and potentially inhumane treatment which originated in the US” was being used on children in the UK using techniques including scheduled holding, binding, rib cage stimulation and/or licking. Similar but less physically coercive approaches may involve holding the child and psychologically encouraging the child to vent anger toward the parent with the intended purpose of making the child “regress” and attach. The induction of anger is done out of the belief that existing anger blocks attachment and must be “drained” before attachment can occur.

The therapy goes under the names of holding therapy, rage reduction therapy, re-birthing and attachment therapy. It actively induces rage and has only the vaguest background in John Bowlby’s renowned theory of attachment.

According to Professor of Psychology, Jean Mercer, in her piece, Adoption and Fostering, “holding therapy has never been shown to be safe and effective by independently-conducted systematic research designed to show results objectively. Rather than an evidence-based treatment, it is one supported primarily by anecdotes and testimonials that come from parents and therapists rather than the children who experienced the treatment.”

That’s what I heard from Dr. Marvin.

In the blog, charlydmiller.com, I read her piece titled, A Near Death Holding Therapy Survivor’s Story, about an email she received from someone who had had a traumatic experience in holding therapy. In short, the patient spoke of the same kind physical restrictions in the sessions and a lasting effect it had on her ability to trust, among other things. But these were from the 1970’s. Still, I got the picture.

Trying to play devil’s advocate, I thought about therapies that I’d experimented with that were perceived by outsiders as “bizarre and inhumane.” In 1979, I did the est training in a hotel room in Boston. Indeed I wasn’t allowed to go to the bathroom and, at one point, I had such a ferocious headache I thought I’d throw up. I raised my hand and was given an airsickness bag. It was uncomfortable but not traumatic. In fact, it was an eye-opening experience. Similarly, in the 1980’s I tried rebirthing. It sounded interesting but was kind of a let down. There was no holding other than comforting by a “facilitator” but I had trouble imagining myself in my mom’s womb, at birth or in infancy. I did my best while other people in the room were clearly having very strong reactions. I must have been doing something wrong.

Which brings me back to Dr. Martha Welch and her 1989 book, Holding Time. Surely this would shed a positive light to balance my report. According to childrenintherapy.org, she was a clinical professor at Columbia with all sorts of impressive credentials and associations. Unfortunately, in 2003, the Acting Chairman of Columbia’s Psychiatry Department distanced himself from her work. “…Dr. Welch does not utilize bonding therapy or related techniques in her work as part of the Department of Psychiatry. Her efforts here are devoted to non-clinical research. Her work on bonding therapy is conducted outside of her departmental activities.”

The site notes that the first (and to date) only published research on Holding Time appeared in 2006 as a pilot study. Among other questionable things in that research, Welch and her associates used Elizabeth Randolph’s un-validated Attachment Disorder Questionnaire (RADQ) for outcome measures. Meanwhile, Holding Time has been embraced by the “gay-to-straight” movement, probably not the best of endorsements, particularly in light of the controversy surrounding Rep. Michelle Bachman’s husband, Marcus, and their “war” on homosexuality.

So much for me trying to be “Fair and Balanced.” I’m still puzzled by those who claim positive results from this controversial practice and invite any of my readers to point me toward something that supports their viewpoint.

9 thoughts on “Holding Therapies – Are They Effective?

  1. Before adopting my daughter, I had never read anything about holding therapies (pros or cons). I still have not really researched the topic. However, The first year she came into our family (at age 6) there where many times I had to hold her in such a way that she did not harm herself. I would sit her on my lap and hold her with her back to me. I would separate her arms with my arms and her legs with my legs (to keep her from the harmful things she would do to herself. Then I would rock and sing to her until she relaxed into my arms. Other times, I would swaddle her in a big fluffy towel, much like a parent would swaddle a newborn in a blanket. The newborn, after being release from the womb out into the wide, wiggly world, finds comfort in swaddling. I personally believe that many orphaned children miss out on this nurturing phase of babyhood. When she was having a massive meltdown, I would swaddle her and hold her snuggly until she relaxed. Then often she would stay in my arms even when I would relax my hold. That was 6 years ago. To this day, she wants to be held. She wants to sit as close to me as possible. She wants me to put an arm around her shoulder or touch her arm.

    But these are not all the things that are needed for attachment. At night time we would put lotion on her legs and arms because her skin was so dry. That began to be a nightly ritual she craved. But more than these, time is needed. Some have said that it can take a year for every year a child is old at the time of adoption for a child to unlearn past behaviors/habits/culture/expectations and adapt to the new. http://nineyearpregnancy.wordpress.com/2012/08/03/year-for-year/

    I’m not a therapist nor a counselor. Just a mom who knows what it is like to adopt an older child who really struggled with attachment…and is now attached.


    • It sounds like you’re experience was quite different from what I’d read about. I just remember that when Casey got into one of her rages, especially as she got older, she simply refused any touching or comfort of any kind.

    • “…until she relaxed.” The child was apparently not comfortable with coercive restraint initially. I would question if this is perceived by the child as “nurturing.”

      Child development researches suggest that restraining a child having a “meltdown” prolongs the event and can have negative long-term outcomes outcomes.

      The time to provide affectionate physical contact is at the invitation of the child.

      • Again, as I said above, it was about protecting her from harming herself. She is now a well-adjusted, well-attached, very affectionate daughter. As parents, it is our responsibility to protect our children…and help them through the grief.

  2. The following is the White Paper put out by ATTACh.org: http://www.attach.org/resources/forms/papers/CoersionWhitePaper.pdf

    There is a difference between traditional “holding therapy” and a containment hold. A containment hold is used for safety only: when a child is a danger to him/her self, to others, or is destroying property. Holding therapy has been seen by many in the attachment community as unnecessarily re-traumatizing.

    Shirley Crenshaw, MSW, LCSW

  3. Wow that was unusual. I just wrote an very long comment
    but after I clicked submit my comment didn’t show up.
    Grrrr… well I’m not writing all that over again. Regardless, just wanted to say wonderful blog!

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