Hugs are integral part of our intimate relationships with others—a sign of affection with friends, family and spouses, and even with strangers we meet along the way. With hugs, we exchange feelings and meanings on non-verbal level which seems rather different from our everyday interaction, deeply entrenched in many words that we utter during one day.
But are hugs allowed in psychotherapy?
The short answer is this: It depends on the therapist and his/her level of comfort. Some therapists gladly offer hugs and some simply don’t. Some firmly believe that their clients should learn to manage on their own, so giving them a hug might be misconstrued by the client and could reinforce already strong dependencies on the therapist, which might not be good for the therapy process and will not engender healing. Others, however, belong to a different school of thought, and give their hugs whenever they are asked to do so. Human touch has most certainly nurturing qualities and, in their opinion, should be used for the benefit of the client—again, only when necessary and only when the therapist is asked to do so. Of course, there are some therapists who are just in the middle—they decide on a case-by-case basis whether it is appropriate or not to give a hug in a specific situation with a particular client.
This question is further burdened with the ethical guidelines for psychotherapists. They are, in principle, not allowed to initiate a hug, because it could be easily misinterpreted and considered as a sign of sexual abuse. Malpractice and misuse of the clients’ trust can have dire consequences and could end in a lawsuit. But what to do if the client asks for a hug, especially in the midst of great emotional turmoil and life crisis? As psychotherapy is also a relationship between two human beings, the therapist is deeply involved in the psychotherapy process, cultivating empathy and unconditional positive regard for the client, and will certainly feel the need to reciprocate. There are risks associated with giving a hug, because the hug could be easily misinterpreted. On the other hand, reluctance to give a hug when asked to do so might also be interpreted by the client as a form of neglect, ignorance or rejection.
So the therapist himself/herself is often in a difficult situation when asked to use this form of non-verbal communication/support and is usually torn between perfectly human need to help a fellow human being in need and his or her professional capacity, therapy goals and risks of misinterpretation and making stronger/unhealthy dependencies between the therapist and the client. Furthermore, there are many other ways in which the therapist can do this and exacerbate the situation with the client—for example, too much self-disclosure, which can have a therapeutic effect, but which can also be very confusing for the client. For instance, this can be the case if self-disclosure takes place too often and more for the benefit of the therapist, leaving the client wondering if this is still a professional relationship or relationship between friends; this can even lead to a role reversal (when the client takes the role of the therapist).
Hugs and any form of touch (except handshake perhaps) lead to the danger of softening limits/boundaries in the therapeutic relationship and breaking these boundaries. This is also connected to the nature of the therapeutic relationship, because it is a professional and intimate relationship at the same time, unlike any other. The danger of blurring the boundaries is a more general problem than simply giving hugs and human touch—that danger is deeply ingrained in the relationship itself between the therapist and the client, since we usually do not share intimate details about ourselves with individuals outside of our network of family and friends, and this new kind of relationship can be, at least in the beginning, very difficult to define for the client. Certainly, this is exactly the reason why the therapeutic relationship can sometimes be a source of great confusion both for the client and the therapist, but it is the responsibility of the therapist to initiate the talk about the boundaries and clarify any potentially confusing situations. Then and only then can the confusion be resolved in a clear and articulated way, making the nature of the relationship (both professional and intimate) truly healing.
The meaning and occurrence of hugs during psychotherapy vary from client to client and therapist to therapist. Every human relationship and interaction is unique and should be treated that way. When we are aware of this simple truth, we can discuss and elaborate on the meanings that we attach to our non-verbal behavior, which makes boundaries between the therapist and the client clear, articulated and healthy, and the therapist’s work ethical. As stated before in the article, the behavior of the therapist can be unethical and unhealthy for the client in many ways which do not necessarily include touch and non-verbal communication. The main recurring question for the therapist should be “Am I helping this person or not?” and that is so often the problem—to determine what is useful and beneficial for the client. Still, there are two persons in the relationship, and psychotherapy could be seen as a form of negotiation and quest for meaning as well. Both the therapist and the client can share their thoughts about the given subject and achieve mutual understanding and respect, so if there is some confusion about what the specific behavior means (including hugs), it can be elaborated on and resolved in a satisfying and ethical way.