Wednesday, November 13, 2013
A New German Book on Festhaltetherapie (Holding Therapy as Practiced by Welch and Prekopova)
A new book, Festhaltetherapie: Ein Pladoyer Gegen Umstritten Therapie…. (Holding Therapy: An Argument Against Controversial Therapies) was published in 2013, and I thank Mrs. Alena Bilkova for calling it to my attention. I hope to get in touch with the editor, Dr. Ute Benz, but I haven’t managed this yet (maybe LinkedIn will do it?).
Festhaltetherapie is a treatment that resembles American “rage-reduction therapy” and other methods that use physical restraint of children in the belief that these procedures have therapeutic effects on psychological problems. Unlike the “classic” American holding therapy, Festhaltetherapie (or, to give its Czech abbreviation, TPO) does not hold the child in the therapist’s lap, use provocative physical prods, or demand that the child shout slogans about wanting to kill people. Festhaltetherapie involves a parent holding a child tightly while the parent expresses feelings about the child and the child cries and struggles, until both are exhausted. Young children are held on the lap facing the parent (usually the mother), but larger children lie on the back with the mother face-to-face on top of them, restraining their hands with her own. Festhaltetherapie is used with autistic children and those who are oppositional by Jirina Prekopova, the Czech proponent of this treatment, but her American counterpart, Martha Welch, now uses her technique “Prolonged Parent-Child Embrace” for treatment of Reactive Attachment Disorder (although she originally saw it as a treatment for autism).
In the 1980s, Prekopova and some German colleagues presented some weak research purporting to give scientific support to the effectiveness of Festhaltetherapie. Before her return to the Czech Republic, however, Prekopova became acquainted with the spiritualist family therapist Burt Hellinger, and her TPO approach now eschews scientific evidence and bases the treatment entirely on the “flow of love” through non-material channels. Prekopova has adopted Hellinger’s view of a hierarchical, patriarchal family power structure that can be healthy only if the child submits to parents completely-- and, by the way, if wives are submissive to husbands. Prekopova now presents Festhaltetherapie as a “lifestyle”, not a treatment, but others continue to promote it as a treatment for autism.
Dr. Ute Bemz and her colleagues wrote their book on Festhaltetherapie in protest against the use of a treatment that is not only ineffective but painful and distressing to children and to families. I have ordered the book from Amazon, but don’t have it yet-- however, from material at http://www.psychosozial-verlag.de/catalog/product_info.php/products-id/2290 I can see a series of intriguing chapters on this little-discussed topic. Here are some chapter titles, in my own clumsy translation (I am translating Festhaltetherapie as holding therapy):
“Power and authority as a therapeutic principle? Methods and psychodynamics of holding”
“Possibilities and limits of parent-infant-toddler psychotherapy”
“Holding therapy in the market of the education industry”
“The attraction of holding therapy for people in the helping professions with the example of occupational therapy”
“Long-term consequences of holding therapy”
“Unmasked pictures. Prekopova in action”
“Consequences and lengthy healing processes in psychotherapy”
“Critical observations on a faulty theory from an analytic perspective”
“ ‘We meant well. Is there trauma in holding therapy?’ Experiences of holding therapy in professional and family contexts.”
“If parents only want the best. Conversation with a mother who believed in holding therapy.”
Of course I can’t tell the contents of these chapters from their titles, but it would appear that they include something I have never seen published before, information from one or more parents who have experienced holding therapy from the parental side. Although people concerned about these restraint therapies ordinarily concentrate on the painful experiences of the child undergoing treatment, as well as with the later anxiety and post-traumatic phenomena reported by adults who were treated when they were children, it seems probable that some parents carrying out holding therapy may also be traumatized as they are instructed to ignore their child’s patent distress.
I also look forward to reading the comments connecting holding therapy with occupational therapy, a discipline that has offered some extraordinarily helpful techniques for children but has also been prone to theories with little empirical support.
A sample of Dr. Benz’s book can be seen at http://www.psychosozial-verlag.de//pdfs/leseprobe/2290.pdf. I’ll translate (again clumsily) a few important remarks:
Bernd Ahrbeck states: “Holding therapy is no safe undertaking. Forcing of attachment on children who have at their disposal no reliable attachment is full of risks. The probability is high that old traumas will be reactivated and new ones established. There should be no illusions about the authoritarian character of holding therapy, even if its proponents are constantly declaring their good intentions and celebrating this treatment as an especially humane method. Anyone who has seen the published videos of holding therapy will not be able to avoid shuddering.
Michael Krentz writes: “The practice of holding therapy, carried on with trivializing ideological-esoteric foundations or camouflaged under veiled terms as ‘supportive and attachment-based pedagogy’ or as ‘attachment holding’ or as ‘reconciliation therapy’, harms the psychological development of the child over the long term.”
If anyone can correct my translations I would appreciate it. I am not sure whether Gewalt in this context should be translated as “abuse” rather than “power”.