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EACH PATIENT BRINGS TO ANALYSIS a unique lifetime of experience comprised of his or her own dynamics, archaic traumas, attachments, separations, and losses. The challenge for the analyst is how to approach these phenomena in the course of analytic treatment. One of the most highly charged questions that arises for many analysts is whether, with particular kinds of patients, nonerotic touch is appropriate and whether it has a place in the analytic milieu.
One of the most thought-provoking analyses of touch in psychoanalysis is Casement's paper (1982), “Some Pressures on the Analyst for Physical Contact During the Reliving of an Early Trauma.” The paper deals with the dilemma Casement faced with a patient's urgent expression of need for physical holding. He felt that actual touching would have been, for the patient, an avoidance rather than a working-through of a painful experience. If he had touched her, Casement felt he would have been rendered useless (what he called “a collapsed analyst”). Unable to bear the patient's psychic pain, he would have succumbed to her wish to have him leave his role. In fact, he believed he would have colluded with her in destroying a very consequential piece of the analysis. Whether one agrees or dis-agrees