Holding therapy

To understand why more than three decades ago in children's psychotherapy a method of behavior correction appeared-holding therapy, it is worth recalling: autism spectrum disorders are a serious pathology that first appears in early childhood.

And people who have had early childhood autism or Kanner's syndrome all their lives have big problems with speech, imagination and social connections: they do not establish close relationships with other people, preferring to remain in their "inner space".

Holding therapy for autism in children is aimed at solving the problem of alienation and lack of contact in this state.

The advantages and disadvantages of holding therapy

Unconditional advantages of holding therapy are that it can help stabilize some reflex reactions of the central nervous system of children with autism, positively influence the development of the child's speech skills, expand the range of his emotional perception and correct changes in behavior.

On the other hand, the shortcomings of holding therapy noted by experts are an excessive stress on the child's psyche. After all, autistic children initially suffer from unwanted contact and eye to eye contact, and an increased level of their negative experiences can cause irreversible changes in behavior and aggravate the mental retardation.

In addition, opponents of this method argue that holding therapy, disrupting the personal space of the child, creates confusion in the views of children about the rules of safe contact and contact with other people. Also, there were cases when during such treatment children were seriously injured.

Moreover, holding therapy in the United States and Great Britain was compromised by the so-called Attachment Therapy, which began to be practiced in the 1990s with the so-called reactive attachment disorder, especially in foster children. In promoting this method, Foster Kline and his colleagues from the psychotherapeutic center in the city of Evergreen (Colorado), also in a number of other American clinics, succeeded.

There, children (and young adolescents) were forcibly physically held in a supine position (sometimes the child was tied up, and two doctors were near him), demanding to look into the eyes of one of the doctors and provoke an attack of rage. And when the helpless child surrendered, calmed down and complied with the demand, he calmly and thoroughly explained that "his parents love him, and he must answer them with obedience and love."

As it turned out later, according to the "protocol of treatment", if the child refused to obey, he could be detained in the clinic or forced to give for a time to another family. In the same way, the reactive attachment disorder in children in the UK was treated.

Despite the fact that Reactive Attachment Disorder entered the ICD-10 (and has the code F94.1), according to the American Academy of Child and Adolescent Psychiatry (AACAP), the question of whether the attachment disorder can be reliably diagnosed in older children, remains open. And thanks to the efforts of the American Professional Community Against Child Abuse (APSAC), after a series of court cases related to the tragic consequences of attachment therapy, in 2007 this method was put on the list of procedures that are potentially dangerous for children.

Indications

Autism in children   is the main diagnosis, in which treatment is applied by holding the child in the mother's arms or, in American terminology, holding therapy.

The author of this applied psychotherapeutic technique is the child psychiatrist, the professor of the Columbia University (Columbia University, the USA) Martha G. Welch (Martha G. Welch). In 1975-1997, while still practicing a children's psychoneurologist, Dr. Welch specialized in the treatment of emotional, behavioral and mental disorders, including autism. Then she began to apply the method of contact rapprochement of an autistic child with his very own people, first of all, his mother. Her practice was based on the attachment theory of John Bowlby, formulated by him in the 1930s, and also on the theory of the ethologist Nikolas Tinbergen, who later (in 1983) wrote the book Autistic Children: A New Hope for Cure (Autistic children: New hope for a cure). Both researchers saw the causes of autism in the insufficient connection between mother and child.

In 1988 Welch's book on this method was published - Holding Time, which for five years was reprinted twice in English and translated into German, Italian, Finnish and Japanese. In the subtitle of the book it was written: "how to eliminate conflicts, tantrums and rivalry and bring up happy, loving and successful children." By the way, it coincided that in the same year the film "Man of the Rain", received by four Oscars, in which the adult autist was brilliantly played by Dustin Hoffman, was released ...

As one of the behavioral methods, holding therapy is aimed at correcting the behavior of autistic children and such symptoms of the disorder as a violation of the emotional ties of the child with the parents, avoiding close contacts, including visual ones. Overcoming the alienation of the child "with special needs" is extremely important for the formation of his sense of security and security, without which the correct emotional development in childhood and adequate socialization in the future is impossible.

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The treatment protocol

The developed technique of conducting daily sessions of holding therapy, each of which lasts about an hour and a half, includes certain, consistently implemented actions. All of them have one goal - through stress and subsequent relaxation to destroy the psycho-emotional "barrier" between the child and the parents.

Without proper prior training of parents, holding therapy is doomed to failure, since all autistic children are opposed to physical contacts and usually begin to resist, break out and scream. Therefore, the children's psychoneurologist should give parents instructions on their behavior during the sessions, talk about how to properly establish contact with the child and build relationships after they are completed.

First, the mother should take the child in her arms, hug him and put her in her arms and - despite the desperate attempts of the child to get free of the embrace - to calm him with tender words, telling him how she loves the baby and how much he means to her. As psychiatrists say, the main task is to hold the child until he relaxes, that is, he stops feeling fear, calms down and clings to his mother. During the sessions the father of the child should help the mother and support her morally, and also calm the child (with soft words and gentle touches).

As the therapy progresses (after several sessions), the mother should teach the child to look at it, and, directly in the eyes. During eye contact, it is recommended to talk with the child, tell the child rhymes-poteshki, sing songs.   

According to experts, most children with an autistic disorder quickly become accustomed to such actions. And holding therapy can be used by parents at any time and regardless of the circumstances - when their child has a feeling of anxiety, confusion or fear (that is, you need to take the baby in your arms, hug and comfort).