Holding Therapy

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Holding Therapy

What is Holding Therapy?

Holding therapy was developed by Dr. Martha Welch in the late 1970s. Dr. Welch was a psychiatrist in New York who began using it with children with autism. Later, she outlined her form of therapy in a book titled, Holding Time (Welch, 1988). Originally, Dr. Welch discovered holding therapy with autistic children. Later, however, she began using this therapy with typical children as well and, in her opinion, discovered equally satisfying results. Welch currently refers to her therapy as Regulatory Bonding Therapy.

Holding therapy is a technique that requires the mother of a child with autism to hold her child for a period of time, even if the child is resisting. The mother holds on to the child until the child accepts contact. Once acceptance is reached, the mother may start to place demands on the child before he or she is released. For example, eye contact may be demanded. Welch suggests that a soft couch or mat is the best place to carry out therapy as there will “usually be a violent physical resistance by the child” (Tinbergen & Tinbergen, 1983, p 325). Below, she outlines some of the practical details of therapy:

The mother is asked to hold the child on her lap, face to face. The father is asked to sit beside and put his arm around the mother. The child sits astraddle the mother with knees bent, one on each side of the mother. The mother places the child’s arms around her and secures them under her arms. She then is free to hold the child’s head with her hands in order to make eye contact. This position is not necessarily comfortable for either person (Tinbergen & Tinbergen, 1983, p 325).

During holding therapy, the therapist acts as an observer and a facilitator. The therapist plays no physical role in the therapy session. Instead, he or she facilitates the “bonding” between mother and child. The therapist confronts the parents about their feelings and encourages the mother to hold tightly and securely. The mother is encouraged to examine her feelings and try to resolve them. Also, it is appropriate to work on conflicts between the two marriage partners and between the father and child during the therapy. Below, are the therapist’s six primary responsibilities, according to Welch (Tinbergen & Tinbergen, 1983):

1. To encourage, exhort or impel the mother to hold the child despite her child’s resistance or her own reservations or inhibitions. 2. To observe and translate the signals the mother and child give, but which each fails to understand. 3. To analyze and interpret the conflicts, first between mother and child, and then between mother and the other important family members. 4. To tolerate the rage and depression the mother and child experience without withdrawing, thus providing an important role model. 5. To engage the father’s help. The mother and father must hold each other. The father at times holds the mother while she holds the child. He must learn to hold the child himself. He must hold the other children while the mother holds the autistic child. 6. To work through the mother’s problems in relating, particularly with her own mother and with her husband.

In addition to holding during therapy times, the parents must be committed to having holding sessions at home. Welch suggests that the mother must hold the child at least once a day and whenever the child seems to be feeling distress. The holding sessions should typically last for one hour.

The Theory Behind Holding Therapy

It is not surprising that holding therapy is rooted firmly in the belief that autism is created by a lack of bonding between mother and child. Martha Welch firmly believed that the mother-child relationship was at the heart of autism. She believed that mothers lacked normal instincts toward their children with autism and that these instincts could be developed through therapy. She said that the...
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