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.