Health & Medical Mental Health

The Meaning of a Handshake for a Psychotherapist

Our handshake conveys more information about us to others than we think, says an American study I read recently.
Researchers at the University of Alabama rated the handshakes of 112 male and female college students for eight characteristics: dryness, temperature, texture, strength, vigour, completeness of grip, duration, and eye contact.
The subjects also completed four personality questionnaires and the results were cross-matched.
Researchers found that handshakes are stable and consistent across time and gender.
The study concludes that handshake characteristics are related to both objective personality measures and to the impressions people form about each other.
Five handshake characteristics in particular (strength, vigour, duration, eye contact and completeness of grip) were used to determine whether a handshake was regarded as firm.
The results confirm the widespread belief that individuals whose handshakes are firmer are more extraverted and open to experience and less neurotic and shy than those with a less firm or limp handshake, and this information about an individual is conveyed to others when they shake hands.
The contributors to Touch Papers: Dialogues on Touch in the Psychoanalytic Space (Galton, 2006) discuss the meaning and significance of many aspects of physical contact in the psychotherapy consulting room.
Several contributors explore what it means for a psychoanalyst or psychotherapist to shake hands, or refrain from shaking hands, with a client.
They comment that in the psychoanalytic community in the United Kingdom there is a general reluctance to shake hands with patients, except sometimes at the beginning and end of treatment.
Many British psychoanalysts and psychoanalytic psychotherapists regard shaking hands with a patient as physical contact which should avoided or kept to a minimum because it disrupts the transference relationship.
We may also wish to consider whether fears of seduction or engulfment may be aroused in a client (or therapist) by the physical contact of a handshake.
As Brett Kahr reminds us in Touch Papers, any physical interaction between two people can trigger unconscious memories of earlier physical interactions, especially those of a provocative or abusive nature.
However, a handshake at the end of a psychotherapy session can also be a sign of an improved capacity for relation with others.
When I recently mentioned to a psychotherapist colleague that I was writing this article about handshakes in the consulting room, she told me of a female client she has been working with for several years.
At the start of treatment her patient had been an inpatient for 18 months and could barely speak.
They have never shaken hands until recently when, at the end of the last session before the summer break, the patient reached out and shook my colleague's hand.
This action was understood by them both as an expression of the patient's emerging capacity for connecting and relating to others and to herself.
In daily life in the UK and North America, after the first meeting it is unusual to shake hands with someone we meet regularly, in contrast to many parts of Europe and South America, where it is usual for people to shake hands every time they meet and again at parting.
Two of the contributors to Touch Papers, although they have lived and worked in the UK for many years, came originally from other countries and cultures where handshaking is done more frequently, even in psychoanalytic circles.
Maria Emilia Pozzi, who was born in Italy, writes in Touch Papers that her first psychoanalyst, in Switzerland, shook her hand at the beginning and end of every session four times a week for several years.
It was a shock when she met her first analyst in London, who never stood up nor shook her hand until the very last session when she herself gathered her courage and initiated a handshake, which she remembers was met by what felt like a slightly embarrassed but responsive shake of the hand.
The psychoanalyst A.
H.
Brafman, who came to the UK from Brazil, writes that he is amused to read discussions that include handshaking as an example of touching the patient.
He recalls his own surprise in his first sessions with his analyst in London when his handshakes prompted interpretations about the unconscious transferential meaning of such behaviour.
Even now, many years later, he remains unconvinced that he was expressing any particular unconscious need by his wish to shake hands.
Another contributor, the distinguished psychoanalyst Pearl King, who is now in her eighties, writes that she always gives patients a welcoming handshake at the first meeting, believing it important to work from a culturally accepted base line.
However, the only other time she shakes the hand of her patients is after the last session before a long break.
It is a firm handshake, in her mind conveying to the patient that she is well and will look after herself while she and the patient are parted, because she knows that her patients have to rely on her not to do anything that could endanger her being there to continue work with them when they return after the break.
The psychoanalyst Valerie Sinason writes in Touch Papers of a very different sort of handshake when she visited an asylum on the Greek island of Leros some years ago.
She describes entering a huge, cold ward that smelled of excrement and in which naked and smeared patients huddled together on old iron beds.
She strode across to one particular over-crowded bed, introduced herself, and held out her hand.
From amongst the mass of human pain, a man with Down's Syndrome untwisted himself and shook her hand.
A year later she met the same young man in the first group home for learning disabled people in Athens.
He opened the door when she rang the bell and they shook hands in an ordinary way.
He was smartly dressed and took her on a tour of the house.
Then he said to her through an interpreter, "I remember you.
You shook my hand on Leros.
" If handshakes really do reveal as much about us as the American study concludes, perhaps shaking hands with our psychotherapy clients might reveal more about us than we wish and so may well interfere with the transference relationship.
On the other hand, if our clients really can learn so much about us from our handshake, how much more might we learn about them from their handshakes? References Galton, G.
(2006).
Touch Papers: Dialogues on Touch in the Psychoanalytic Space.
(London: Karnac).
This article was first published in Karnac Review, Issue 10 2006 Graeme Galton

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